Both type 1 and type 2 diabetes became increasingly common among kids and teens in the U.S. between 2001 and 2009, according to a new study.
Though researchers can’t say why exactly these rates continue to go up, it is important to monitor them, Dr. Dana Dabelea told Reuters Health.
Dabelea worked on the study at the Colorado School of Public Health in Aurora.
“This should draw attention to the seriousness of pediatric diabetes especially for the clinical and public health community,” she said. “At the individual level, every new case of diabetes at a young age means a lifelong burden of difficult, expensive treatment and a high risk of complications.”
Dabelea and her team analyzed data from health plans in California, Colorado, Ohio, South Carolina and Washington state, as well as from American Indian reservations in the Southwest, including more than 3 million patients under age 19.
In 2001, about 14.8 kids in every 10,000 were diagnosed with type 1 diabetes, formerly known as “juvenile diabetes,” in which the body’s own immune system destroys insulin-producing cells in the pancreas. Insulin is needed to remove sugar from the bloodstream so it can be used for energy.
By 2009, that rate had risen to 19.3 kids in every 10,000, a 21 percent increase, the authors found. Type 1 diabetes was most common among white children.
In type 2 diabetes, which is much more common but not usually diagnosed until adulthood, the body still makes insulin but can’t use it effectively. For the current study, the authors looked at type 2 diabetes among kids ages 10 and up.
Among that group in 2001, 3.4 kids in every 10,000 were diagnosed with type 2 diabetes, which increased to 4.6 per 10,000 in 2009, a 31 percent increase. This type of diabetes was most common among American Indian and black youth.
The results were published online Saturday in the Journal of the American Medical Association, to coincide with a presentation at the annual meeting of the Academic Pediatric Societies, held this year in Vancouver, Canada.
Though the study covered a large number of kids, it only included data from two years. So it’s hard to say there was a steady increase in diabetes among kids throughout the country over the same time period, the authors say.
Still, the increase they saw was larger than expected, according to Dabelea, especially given that other recent studies have found obesity rates in the U.S. have finally started to plateau (see Reuters story of August 16, 2013 here: reut.rs/1iWcaVi).
Obesity, along with diet and lifestyle, is closely linked with type 2 diabetes.
“The obesity rates in the U.S. have been relatively stable since 2003-04 with a decline in rates recently, mainly in younger children rather than in older children, so I am not too surprised in the continued rise in type 2 (diabetes) in youth from 2001 to 2009, but I am hopeful that the rate of type 2 in youth will level off over the next five years,” Dr. Georgeanna J. Klingensmith told Reuters Health in an email.
Klingensmith, from the Barbara Davis Center for Childhood Diabetes at the University of Colorado School of Medicine in Aurora, was not part of the new study.
“I do think that we are better at diagnosing type 2 diabetes in youth today than we were 10-15 years ago, so part of the increase in type 2 diabetes may be related to improved detection of diabetes due to screening children at high risk,” she said.
The increase in type 2 diabetes seemed mostly to be driven by increases among minority populations, Dabelea said.
“Since minorities typically have less optimal (blood sugar) control, less access to care and more obesity, these are strong risk factors for type 2 diabetes,” she said.
Type 1 diabetes is not caused by obesity, so it could become more common regardless of U.S. obesity rates, Klingensmith said.
It’s still unclear what exactly causes type 1 diabetes, but it has been steadily increasing in European countries as well, Dabelea said.
“For type 1 we can’t really advise families to do anything differently,” she said.
“For type 2 diabetes on the other hand, since that’s so closely related to obesity it’s likely that implementing programs for kids and families being careful of certain things from very early in life is going to be important.”
To protect against type 2 diabetes, parents should help their children avoid excessive weight gain, eat less fried food and more fresh vegetables and get 30 to 60 minutes of exercise per day, Klingensmith said.
SOURCE: Journal of the American Medical Association, online May 3, 2014
Prevalence of Type 1 and Type 2 Diabetes Among Children and Adolescents From 2001 to 2009 FREE
Importance Despite concern about an “epidemic,” there are limited data on trends in prevalence of either type 1 or type 2 diabetes across US race and ethnic groups.
Objective To estimate changes in the prevalence of type 1 and type 2 diabetes in US youth, by sex, age, and race/ethnicity between 2001 and 2009.
Design, Setting, and Participants Case patients were ascertained in 4 geographic areas and 1 managed health care plan. The study population was determined by the 2001 and 2009 bridged-race intercensal population estimates for geographic sites and membership counts for the health plan.
Conclusions and Relevance Between 2001 and 2009 in 5 areas of the United States, the prevalence of both type 1 and type 2 diabetes among children and adolescents increased. Further studies are required to determine the causes of these increases.
Dana Dabelea, MD, PhD; Elizabeth J. Mayer-Davis, PhD; Sharon Saydah, PhD; Giuseppina Imperatore, MD; Barbara Linder, MD, PhD; Jasmin Divers, PhD; Ronny Bell, PhD; Angela Badaru, MD; Jennifer W. Talton, MS; Tessa Crume, PhD; Angela D. Liese, PhD; Anwar T. Merchant, DMD, ScD; Jean M. Lawrence, ScD, MPH, MSSA; Kristi Reynolds, PhD; Lawrence Dolan, MD; Lenna L. Liu, MD, MPH; Richard F. Hamman, MD, DrPH ; for the SEARCH for Diabetes in Youth Study