Disclosures: The authors report no relevant financial disclosures.
August 24, 2021
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Prevalence of diabetes in youth increased significantly since 2001

Disclosures: The authors report no relevant financial disclosures.
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The estimated prevalence of type 1 and type 2 diabetes increased significantly among children and adolescents in the U.S. from 2001 to 2017, according to findings published in JAMA.

The data showed a larger increase in type 2 diabetes; however, type 1 diabetes is still more common than type 2 diabetes in youth, according to Jean M. Lawrence, ScD, MPH, MSSA, FACE, program director of diabetes epidemiology at the National Institute of Diabetes and Digestive and Kidney Diseases.

Relative increase in diabetes among adolescents
Lawrence JM, et al. JAMA. 2021;doi:10.1001/jama.2021.11165.

“Our findings of increases in prevalence of both type 1 and type 2 diabetes among youth means that a greater number of children and adolescents will have diabetes as they age into adulthood,” she told Healio Primary Care. “These people will need to incorporate diabetes management into their daily lives and will be at risk for experiencing diabetes-related complications.”

Lawrence and colleagues conducted a cross-sectional observational study of 3.35 million individuals aged younger than 20 years to estimate changes in diabetes prevalence. The data were collected from certain counties in six geographic areas, including California, Colorado, Ohio, South Carolina, Washington and select American Indian reservations in Arizona and New Mexico. The researchers compared data from 2001, 2009 and 2017, analyzing the prevalence overall as well as by race, ethnicity, age and sex.

Jean M. Lawrence

Type 1 diabetes

During the study period, the estimated prevalence of type 1 diabetes increased from 148 per 100,000 youths in 2001 to 215 per 100,000 youths in 2017, according to Lawrence. There was an absolute increase of 0.67 (95%, CI, 0.64-0.7) per 1,000 youths and a relative increase of 45.1% (95% CI, 40-50.4) over 16 years, the researchers wrote. The largest absolute increases were among non-Hispanic Black (0.89 per 1,000 youths) and non-Hispanic white (0.93 per 1,000 youths) participants. Overall, the estimated prevalence of type 1 diabetes resulted in 0.72 to 1.7 additional cases per 1,000 Black, Hispanic and white youth, according to the researchers.

Type 2 diabetes

For type 2 diabetes, the prevalence increased among those aged 10 to 19 years, from 34 per 100,000 in 2001 to 67 per 100,000 in 2017, Lawrence said. The researchers excluded children aged 9 years and younger due to a limited sample size.

The data yielded an absolute increase of 0.32 (95% CI, 0.3-0.35) per 1,000 youths and a relative increase of 95.3% (95% CI, 77-115.4) over 16 years. Non-Hispanic Black and Hispanic youths experienced the greatest absolute increases in type 2 diabetes, with an increase of 0.85 per 1,000 youths and 0.57 per 1,000 youths, respectively. The researchers estimated that there was one additional case of type 2 diabetes per 1,000 youths among Black and Hispanic female participants aged 15 to 19 years.

“Type 2 diabetes in youth is associated with obesity, exposure to maternal diabetes and obesity during pregnancy, family history and genetics,” Lawrence said. “Health care providers can play an important role in helping children, adolescents and their families learn about the importance of having a healthy lifestyle and achieving and maintaining a healthy weight.”