Uptick in Diabetes Cases Seen Among Youth

The prevalence of type 1 and type 2 diabetes rose in the early 21st century among adolescents in the U.S., researchers said here.

Between 2001 and 2009, prevalence of type 1 disease rose 23% and prevalence of type 2 rose 21%, said Dana Dabelea, MD, PhD, of the University of Colorado in Denver, and colleagues during a press briefing at the American Diabetes Association meeting.

While escalating rates of type 2 diabetes go hand-in-hand with an ongoing obesity epidemic, the reasons for rises in rates of type 1 disease are less clear, Dabelea said.

The data for two studies done by Dabelea's group come from the SEARCH for Diabetes in Youth Study, looking at teens and adolescents under age 20 from regions in Ohio, Colorado, Washington, and South Carolina between 2001 and 2009.

Overall, about 189,000 youths had diabetes in 2009: 168,000 with type 1 and 19,000 with type 2.

The prevalence per 1,000 cases cases was 1.55 (95% CI 1.5-1.6) in 2001 and 2.04 (95% CI 1.99-2.1) in 2009. After adjustment for completeness of ascertainment, the prevalence per 1,000 cases was 1.67 (95% CI 1.62-1.72) in 2001 and 2.06 (95% CI 2.01-2.12) in 2009.

Fast Facts on Diabetes Diabetes affects 25.8 million people of all ages 8.3 percent of the U.S. population

DIAGNOSED

18.8 million people

UNDIAGNOSED

7.0 million people

Dabelea said there was an increase for most ethnic groups, with the exception of Native Americans, for whom overall numbers were generally small.

In a subanalysis done in Caucasians only, the researchers found that the annual rise in type 1 diabetes was 2.6% during this time period.

Dabelea said it's unclear why type 1 disease is on the rise, though it may fall under the 'hygiene hypothesis," which posits that young children are less exposed to bacteria and viruses that are important in immune system development.

There may also be some environmental factors that prompt children to grow faster and gain more weight early in life, she said, which could put a heavy burden on the pancreas, overloading beta cells and leading to autoimmune attack.

For type 2 disease, prevalence rose 21% between 2001 and 2009, from 2.9 per 10,000 cases to 3.6 per 10,000 cases, the researchers found (P=0.007).

The increases were seen is boys and girls, and in all age groups over 10. Dabelea noted that type 2 disease is "still exceptionally rare" in kids under that age.

The highest prevalence of disease occurred among Native Americans and African Americans, but rates remained flat over time, she said.

Instead, the bulk of the increase occurred among whites and Hispanics. "Pediatric type 2 disease is plateauing in high-risk patients but is still catching up in other racial-ethnic groups," Dabelea said.