Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009
Dana Dabelea, Elizabeth J Mayer-Davis, Sharon Saydah, Giuseppina Imperatore, Barbara Linder, Jasmin Divers, Ronny Bell, Angela Badaru, Jennifer W Talton, Tessa Crume, Angela D Liese, Anwar T Merchant, Jean M Lawrence, Kristi Reynolds, Lawrence Dolan, Lenna L Liu, Richard F Hamman, SEARCH for Diabetes in Youth Study, Jean M Lawrence, Kristi Reynolds, Mary Helen Black, Harpreet S Takhar, Kim Holmquist, Jin-Wen Hsu, David J Pettitt, Dana Dabelea, Richard F Hamman, Lisa Testaverde, Georgeanna J Klingensmith, Marian J Rewers, David Maahs, Paul Wadwa, Stephen Daniels, Kristen Nadeau, Clifford A Bloch, Carmelita Sorrelman, Jeffrey Powell, Susie John, Kathy Love-Osborne, Carol Greenlee, Lawrence M Dolan, Michael Seid, Elaine Urbina, Amy Shah, Debra A Standiford, Elizabeth J Mayer-Davis, Joan Thomas, Pam Clark, Mark Parker, Anwar Merchant, Angela D Liese, Robert R Moran, Gladys Gaillard-McBride, Malaka Jackson, Lisa Knight, Deborah Bowlby, James Amrhein, Bryce Nelson, Catherine Pihoker, Maryam Afkarian, Angela Badaru, Lisa Gilliam, Irl Hirsch, Lenna L Liu, John Neff, Joyce Yi-Frazier, Beth Loots, Rebecca O'Connor, Sue Kearns, Mary Klingsheim, Emil Buscaino, Katherine Cochrane, Onel Martinez, Sharla Semana, Carla Greenbaum, Giuseppina Imperatore, Desmond E Williams, Henry S Kahn, Bernice Moore, Gregg W Edward, Sharon H Saydah, Barbara Linder, Santica M Marcovina, Vinod P Gaur, Jessica Harting, Ronny Bell, Ralph D'Agostino Jr, Jasmin Divers, Wei Lang, Timothy Morgan, Michelle Naughton, Leora Henkin, Gena Hargis, Maureen T Goldstein, Jeanette Andrews, Nora Fitzgerald, Scott Isom, Jennifer Talton, Dana Dabelea, Elizabeth J Mayer-Davis, Sharon Saydah, Giuseppina Imperatore, Barbara Linder, Jasmin Divers, Ronny Bell, Angela Badaru, Jennifer W Talton, Tessa Crume, Angela D Liese, Anwar T Merchant, Jean M Lawrence, Kristi Reynolds, Lawrence Dolan, Lenna L Liu, Richard F Hamman, SEARCH for Diabetes in Youth Study, Jean M Lawrence, Kristi Reynolds, Mary Helen Black, Harpreet S Takhar, Kim Holmquist, Jin-Wen Hsu, David J Pettitt, Dana Dabelea, Richard F Hamman, Lisa Testaverde, Georgeanna J Klingensmith, Marian J Rewers, David Maahs, Paul Wadwa, Stephen Daniels, Kristen Nadeau, Clifford A Bloch, Carmelita Sorrelman, Jeffrey Powell, Susie John, Kathy Love-Osborne, Carol Greenlee, Lawrence M Dolan, Michael Seid, Elaine Urbina, Amy Shah, Debra A Standiford, Elizabeth J Mayer-Davis, Joan Thomas, Pam Clark, Mark Parker, Anwar Merchant, Angela D Liese, Robert R Moran, Gladys Gaillard-McBride, Malaka Jackson, Lisa Knight, Deborah Bowlby, James Amrhein, Bryce Nelson, Catherine Pihoker, Maryam Afkarian, Angela Badaru, Lisa Gilliam, Irl Hirsch, Lenna L Liu, John Neff, Joyce Yi-Frazier, Beth Loots, Rebecca O'Connor, Sue Kearns, Mary Klingsheim, Emil Buscaino, Katherine Cochrane, Onel Martinez, Sharla Semana, Carla Greenbaum, Giuseppina Imperatore, Desmond E Williams, Henry S Kahn, Bernice Moore, Gregg W Edward, Sharon H Saydah, Barbara Linder, Santica M Marcovina, Vinod P Gaur, Jessica Harting, Ronny Bell, Ralph D'Agostino Jr, Jasmin Divers, Wei Lang, Timothy Morgan, Michelle Naughton, Leora Henkin, Gena Hargis, Maureen T Goldstein, Jeanette Andrews, Nora Fitzgerald, Scott Isom, Jennifer Talton
Abstract
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.
Main outcomes and measures: Prevalence (per 1000) of physician-diagnosed type 1 diabetes in youth aged 0 through 19 years and type 2 diabetes in youth aged 10 through 19 years.
Results: In 2001, 4958 of 3.3 million youth were diagnosed with type 1 diabetes for a prevalence of 1.48 per 1000 (95% CI, 1.44-1.52). In 2009, 6666 of 3.4 million youth were diagnosed with type 1 diabetes for a prevalence of 1.93 per 1000 (95% CI, 1.88-1.97). In 2009, the highest prevalence of type 1 diabetes was 2.55 per 1000 among white youth (95% CI, 2.48-2.62) and the lowest was 0.35 per 1000 in American Indian youth (95% CI, 0.26-0.47) and type 1 diabetes increased between 2001 and 2009 in all sex, age, and race/ethnic subgroups except for those with the lowest prevalence (age 0-4 years and American Indians). Adjusted for completeness of ascertainment, there was a 21.1% (95% CI, 15.6%-27.0%) increase in type 1 diabetes over 8 years. In 2001, 588 of 1.7 million youth were diagnosed with type 2 diabetes for a prevalence of 0.34 per 1000 (95% CI, 0.31-0.37). In 2009, 819 of 1.8 million were diagnosed with type 2 diabetes for a prevalence of 0.46 per 1000 (95% CI, 0.43-0.49). In 2009, the prevalence of type 2 diabetes was 1.20 per 1000 among American Indian youth (95% CI, 0.96-1.51); 1.06 per 1000 among black youth (95% CI, 0.93-1.22); 0.79 per 1000 among Hispanic youth (95% CI, 0.70-0.88); and 0.17 per 1000 among white youth (95% CI, 0.15-0.20). Significant increases occurred between 2001 and 2009 in both sexes, all age-groups, and in white, Hispanic, and black youth, with no significant changes for Asian Pacific Islanders and American Indians. Adjusted for completeness of ascertainment, there was a 30.5% (95% CI, 17.3%-45.1%) overall increase in type 2 diabetes.
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.
Conflict of interest statement
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Liese reported that she has received grant support from the National Institutes of Health, Centers for Disease Control and Prevention (CDC), American Diabetes Association, American Heart Association, US Department of Agriculture, Juvenile Diabetes Research Foundation, and the US Army Medical Research Acquisition Activity; personal fees from the National Institutes of Health and the US Department of Agriculture; and Dr Reynolds reported receiving grant support from Merck. No other financial disclosures were reported.
Source: PubMed