Trends in the incidence of youth-onset type 1 and type 2 diabetes in the US, 2002–18 : results from the SEARCH for Diabetes in Youth population-based study Summary Background The incidence of diabetes is increasing in children and young people. Our objective was to describe the incidence of type 1 and type 2 diabetes in children and young people under 20 years of age over a 17-year period. Methods The SEARCH for Diabetes in Youth study identified children and youth ages 0 to 19 years with a medical diagnosis of type 1 or type 2 diabetes at five centers in the US between 2002 and 2018. Eligible participants included non-military and non-institutionalized who resided in one of the study areas at the time of diagnosis. The number of children and youth at risk of diabetes was obtained from the census or count of health plan members. Generalized autoregressive moving average models were used to examine trends, and data are presented as incidence of type 1 diabetes per 100,000 children and youth aged 20 years and younger and incidence of type 2 diabetes per 100,000 children and youth aged 10 years and younger. and those under 20 years of age in categories of age, sex, race or ethnicity, geographic region, and month or season of diagnosis. Results We identified 18,169 children and young people aged 0 to 19 years with type 1 diabetes in 85 million person-years and 5293 children and young people aged 10 to 19 years with type 2 diabetes in 44 million person-years. In 2017-18, the annual incidence of type 1 diabetes was 22.2 per 100,000 and that of type 2 diabetes was 17.9 per 100,000. The trend model captured both a linear effect and a moving average effect, with an increasing (yearly) linear effect significant for both type 1 diabetes (2.02% [95% CI 1.54–2.49]) and for type 2 diabetes (5.31% [4.46–6.17]). Children and youth from racial and ethnic minority groups, such as Hispanic and non-Hispanic black children and youth, had greater increases in the incidence of both types of diabetes. The maximum age at diagnosis was 10 years (95% CI 8-11) for type 1 diabetes and 16 years (16-17) for type 2 diabetes. Season was significant for type 1 diabetes ( p=0·0062) and type 2 diabetes (p=0·0006), with a peak of type 1 diabetes diagnoses in January and a peak of type 2 diabetes diagnoses in August. Interpretation The increasing incidence of type 1 and type 2 diabetes in children and youth in the US will result in an expanding population of young adults at risk of developing early complications of diabetes whose health care needs will exceed those of their peers. Findings regarding age and season of diagnosis will inform focused prevention efforts. |
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New findings from researchers at Wake Forest University School of Medicine confirm that rates of type 1 and type 2 diabetes continue to rise in children and young adults. Non-Hispanic black and Hispanic children and young adults also had higher rates of diabetes incidence. The study appears online in the current issue of The Lancet Diabetes & Endocrinology .
"Our research suggests a growing population of young adults with diabetes who are at risk of developing complications from the disease," said Lynne E. Wagenknecht, Ph.D., professor and director of public health sciences at the University College of Medicine. Wake Forest University and research director. “It is a worrying trend in young people whose health care needs will exceed those of their peers.”
The findings come from the final report of the SEARCH for Diabetes in Youth study, the largest diabetes surveillance effort among youth under 20 years of age in the U.S. to date. Wake Forest University School of Medicine served as the coordinating center for the multi-site study, which launched in 2000 and was supported by the Centers for Disease Control and Prevention and the National Institutes of Health.
The research team identified more than 18,000 children and youth from infants to age 19 with a medical diagnosis of type 1 diabetes and more than 5,200 youth ages 10 to 19 with type 2 diabetes at five U.S. centers. between 2002 and 2018. The annual incidence of type 1 diabetes was 22.2 per 100,000 in 2017–18 and 17.9 per 100,000 for type 2 diabetes.
“In our 17-year analysis, we found that the incidence of type 1 diabetes increased 2% per year, and the incidence of type 2 diabetes increased 5.3% per year,” Wagenknecht said.
Rates of increase were also higher among racial and ethnic groups than among non-Hispanic white children. Specifically, the annual percentage increases for type 1 diabetes and type 2 diabetes were highest for Asian/Pacific Islander, Hispanic, and non-Hispanic black children and youth.
The maximum age at diagnosis was 10 years for type 1 diabetes and 16 years for type 2 diabetes. The researchers also noted that the onset of type 1 diabetes generally occurs in winter with a peak in January. Possible explanations for this seasonality include fluctuating daylight hours, lower vitamin D levels, and an increase in viral infections.
For type 2 diabetes, the peak onset was in August. Researchers attribute this to the increase in sports physicals and routine health screenings that occur more frequently at the beginning of the academic school year.
“These findings will help guide focused prevention efforts,” Wagenknecht said. “Now that we have a better understanding of the risk factors, our next phase of research will be to study the underlying pathophysiology of juvenile diabetes.”
