Rates of Diabetes Increasing in U.S. Youth
The SEARCH for Diabetes in Youth study has provided new data on the prevalence (proportion of the population with the disease) and incidence (proportion of the population who develop the disease each year) of both type 1 and type 2 diabetes in a geographically and racially/ethnically diverse group of children and teens. This information will help researchers identify trends and potential causes of the disease, which is a significant health problem in the United States.
SEARCH researchers found that between 2001 and 2009, both types of diabetes became increasingly prevalent in youth under 20 years of age. Type 1 diabetes remains the predominant form in youth, with about four times as many youth affected with type 1 diabetes than with type 2 diabetes. Except in American Indians, type 1 diabetes accounts for nearly all diabetes in children under the age of 10. However, prevalence of type 2 diabetes is increasing more rapidly. Overall, the proportion of youth with type 2 diabetes rose by 30.5 percent while the proportion with type 1 diabetes rose by about 21 percent.
The increase in type 1 diabetes prevalence was seen in both sexes and in White, Black, Hispanic, and Asian Pacific Islander youth. Historically, type 1 diabetes has been considered to affect primarily non-Hispanic White youth; the new data demonstrate that it is also an increasing burden for minority youth. Additionally, SEARCH found that rates of new cases of type 1 diabetes increased by about 2.7 percent per year in non-Hispanic White youth, with the increase seen in both males and females and in all age groups except the youngest (0- to 4-year-olds).
Once considered a disease of adults, type 2 diabetes has emerged as a significant health issue among U.S. youth, spurred by the prevalence of obesity, a strong risk factor for this form of diabetes. SEARCH found significant increases in type 2 diabetes prevalence between 2001 and 2009 in both sexes, all age-groups, and in White, Hispanic, and Black youth. While there were no significant changes for Asian Pacific Islanders and American Indians, American Indians had rates ten-fold greater than in White youth. Overall, the highest prevalence was found in American Indians, followed by Black, Hispanic, and Asian Pacific Islander youth, with lowest prevalence in White youth. These results demonstrate the increasing burden of type 2 diabetes on youth of minority racial/ethnic groups.
Increases in both type 1 and type 2 diabetes prevalence and incidence in youth are worrying because these populations face unique challenges in managing their diabetes and may be at greater risk of diabetic complications later in life due to their long disease duration. Collectively, the SEARCH findings provide critical information on recent trends in diabetes in U.S. youth and will help inform future planning, research, and policies aimed at relieving the burden of diabetes.
Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J, Bell R, Badaru A, Talton JW, Crume T, Liese AD, Merchant AT, Lawrence JM, Reynolds K, Dolan L, Liu LL, Hamman RF; SEARCH for Diabetes in Youth Study. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA 311:1778-1786, 2014.