A broad scale, five-state study published in the latest issue of the New England Journal of Medicine found that from 2002-2012 the yearly rate of newly-diagnosed cases of both type 1 and type 2 diabetes in youth increased significantly and steadily over the 10-year period, especially among Hispanic youth.
The 10-year study, co-led by The University of North Carolina’s Department of Nutrition Chair Elizabeth Mayer-Davis, PhD, found there was an average of 1.8 percent increase each year of youth with newly-diagnosed type 1 diabetes and an average of 4.8 percent per year increase of newly-diagnosed type 2 diabetes cases among the same population.
“Much attention has been paid to the increase in type 2 diabetes in youth,” says Mayer-Davis, who, in addition to being chair of the Department of Nutrition in the UNC School of Medicine and the UNC Gillings School of Global Public Health, is also the Cary C. Boshamer Distinguished Professor of Nutrition and Medicine. “However, the rate of new cases of type 1 diabetes in youth has also been increasing in this same time period. This is especially important because overall, most youth with diabetes have type 1 diabetes.”
Mayer-Davis added that type 1 diabetes is an autoimmune disease in which use of insulin shots or an insulin pump is required to control blood sugar, whereas type 2 diabetes is commonly associated with overweight or obese individuals, and may or may not require insulin as part of treatment.
The study, “SEARCH for Diabetes in Youth,” included 11,244 youth with type 1 (ages 0-19) and 2,846 with type 2 diabetes (ages 10-19) who were diagnosed with diabetes between 2002 and 2012. There were close to 5 million youth under surveillance from five clinical centers in the United States. The cohort included youth from seven counties in Southern California, all of Colorado as well as selected American Indian reservations in Arizona and New Mexico, all of South Carolina, eight counties in Ohio, and five counties in Washington. The study was co-led by Dana Dabelea, MD, PhD, from the University of Colorado.
“For both type 1 and type 2 diabetes, the increase in the rate of new cases diagnosed was higher for youth of minority race or ethnicity, compared to white youth,” Mayer-Davis says. “This was expected for type 2 diabetes. In fact, for type 2 diabetes, we saw increases for all racial and ethnic groups except among white youth. But while the overall incidence rate of type 1 diabetes remains highest among white youth, the fastest increase occurred for Hispanic youth, which is something we didn’t expect to see.”
Hispanic youth saw a rise of 4.2 percent per year of type 1 diabetes cases compared to 1.2 percent per year for non-Hispanic white youth.
In their discussion of the findings, the researchers indicated that these increases in incidence of type 1 and type 2 diabetes suggest a growing disease burden that will not be shared equally. The data suggest an increasingly urgent need to identify approaches to reduce race and ethnic disparities in access to the health care, education and support to best care for youth with diabetes.
Researchers noted that these steady increases in type 1 and type 2 found among youth present a pivotal moment in health care as the diseases continue to expand across race and ethnicity, for both boys and girls.
“Both type 1 and type 2 diabetes present lifelong challenges to maintain good health, including significant medical and lifestyle choices,” Mayer-Davis says. “Diabetes brings risks for both acute and chronic complications, including increased risk for heart disease, kidney disease, and diabetic eye disease. Ongoing surveillance for trends in both type 1 and type 2 diabetes will be critical for planning for the care and support that individuals with diabetes will need.”
Funding
The Population Based Registry of Diabetes in Youth Study is funded by the CDC and by the NIDDK.
The SEARCH for Diabetes in Youth Cohort Study is funded by the National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and by the Centers for Disease Control and Prevention (CDC).