People with either type 1 or type 2 diabetes have high blood sugar. Type 1 occurs when the pancreas does not make enough insulin to metabolize the sugar. Patients with type 2 diabetes make insulin, but it does not work well enough to lower blood sugar levels.
To look at trends in type 1 and type 2 diabetes in children and teens, a research team examined data from 2001 to 2009 in several ethnic groups and geographic areas.
These researchers found significant increases in the rate of both types of diabetes. Type 1 diabetes occurred most frequently in white children, and the rate of type 2 diabetes was highest among American Indian youths.
"Take your child for regular checkups with a pediatrician."
Dana Dabelea, MD, PhD, from the Department of Epidemiology at the Colorado School of Public Health in Aurora, Colorado, and Elizabeth J. Mayer-Davis, PhD, from the Department of Nutrition at the University of North Carolina at Chapel Hill, led this research team.
The researchers obtained data collected between 2001 and 2009 on over 3 million youths from several geographic areas, including California, Ohio, Colorado, South Caroline, Washington state and American Indian reservations in New Mexico and Arizona.
They collected information from medical records to determine diagnosis of type 1 and type 2 diabetes and date of diabetes diagnosis.
Youth younger than age 20 were included in the data analysis for type 1 diabetes. Due to small numbers of patients below the age of 10, only those between the ages of 10 and 19 were included in the type 2 diabetes analysis.
Type 1 diabetes was diagnosed in 4,958 of the 3,345,783 youths in the study population in 2001 and 6,666 of the 3,458,974 patients in 2009, representing an overall increase over these years of just over 21 percent.
In 2001, the rate of type 1 diabetes was 1.48 cases per every 1,000 youths. In 2009, the rate was 1.93 cases per 1,000 youths.
There was a significant increase in type 1 diabetes in each age group, race or ethnic category and gender, with the exception of children ages 0 through 4 years old and American Indians.
The rate of type 1 diabetes in 2009 was highest in white youths, at 2.55 cases per 1,000 youths and lowest in American Indians, at 0.35 cases per 1,000 youths.
The researchers identified 588 case of type 2 diabetes among the 1,725,846 youths in 2001 and 819 cases among the 1,781,260 youths in 2009. These rates represented a 30.5 percent increase in diagnosed cases of type 2 diabetes in this age group from 2001 to 2009.
The incidence of type 2 diabetes in these children overall was 0.34 cases per 1,000 youths in 2001 and 0.46 cases per 1,000 youths in 2009. In 2009, the incidence rate in American Indians was the highest, at 1.20 cases per 1,000 children and lowest in whites, at 0.17 cases per 1,000 children.
These findings represented significant increases in the rate of type 2 diabetes in both genders, in youths aged 10 through 14 and 15 through 19 and in white, black and Hispanic children.
The authors of this study explained that rates of diabetes incidence are determined by several factors. They noted that the larger number of cases of children with diabetes seen in 2009 compared to 2001 could be due to new cases of diabetes, a decrease in death from diabetes during that time period or both. Since death rates from diabetes in youth are low, the researchers felt that the diabetes occurrence rates observed in their study were probably due to an actual increase in the number of cases of type 1 diabetes, not a decrease in children dying of the disease.
Type 2 diabetes may have increased, according to the authors, because of changing risk factors for type 2 diabetes, such as an increase in at-risk minority groups, obesity or exposure to diabetes before birth.
The study's authors noted that their research may have been limited by the fact that they only included diagnosed cases of diabetes and may have missed some cases. The small number of patients in some of the groups may also have been a limitation of the study.
"Understanding changes in prevalence according to population subgroups is important to inform clinicians about care that will be needed for the pediatric population living with diabetes and may provide direction for other studies designed to determine the causes of the observed changes," these authors wrote.
"The increases in prevalence reported herein are important because such youth with diabetes will enter adulthood with several years of disease duration, difficulty in treatment, an increased risk of early complications, and increased frequency of diabetes during reproductive years, which may further increase diabetes in the next generation," they concluded.
"The increasing levels of diabetes in children between 2001 and 2009 as reported in JAMA in May is even more ominous coupled with a report from the Annals of Internal Medicine in April of this year indicating the levels of diabetes in adults has doubled over the past 20 years," said Dr. Barry Sears, President of the non-profit Inflammation Research Foundation in Marblehead, MA and creator of The Zone Diet.
"This new report in the increase in children only indicates that there will be a growing driving force for continued escalation of our current diabetes epidemic in the future," Dr. Sears told dailyRx News.
This research was published May 6 in JAMA.
Funding for the research was provided by grants from the Centers for Disease Control and Prevention (CDC) and by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Two of the authors made financial disclosures. Angela D. Leise, PhD, received grant support from NIH and CDC, as well as personal fees from NIH and the US Department of Agriculture. Kristi Reynolds, PhD, received grant support from Merck.