Increased prevalence of type 1 and type 2 diabetes observed in youths in the United States, 2001 to 2017
1. This cross-sectional study discovered that the estimated prevalence of both type 1 and type 2 diabetes among youths in the United States increased from 2001 to 2017.
2. The most substantial increases were observed in non-Hispanic White and non-Hispanic Black youths for type 1 diabetes and non-Hispanic Black and Hispanic youths for type 2 diabetes.
Evidence Rating Level: 3 (Average)
Study Rundown: Individuals with youth-onset type 1 and type 2 diabetes are at risk of developing complications and comorbidities early on in life resulting in increased mortality, especially among those from racial and ethnic minority groups. Between 2001 and 2009, an increase in the prevalence and incidence of youth-onset diabetes in the US was observed in the SEARCH for Diabetes in Youth Study, where an estimated 187,246 youths 19 years or younger were diagnosed with diabetes. The largest relative percent increases in incidence were observed among racial minority groups. This cross-sectional study used data from 2001, 2009, and 2017 to observe trends in youth-onset diabetes prevalence and establish whether there were any differences when stratifying by diabetes type, race and ethnicity, age, and sex. The analysis was able to elucidate differences in youth-onset diabetes prevalence by diabetes type and demographic characteristics and will help anticipate current and future needs in health care resources. The main endpoint of the analysis was the estimated prevalence of physician-diagnosed type 1 and type 2 diabetes among under-20 youths overall and by race and ethnicity, age, and sex. Among an average of 3.47 million youths for each year of study from 6 US regions, the estimated prevalence of type 1 diabetes among individuals 19 years or younger increased significantly from 1.48 per 1000 youths in 2001 to 2.15 per 1000 youths in 2017. Furthermore, the estimated prevalence of type 2 diabetes among individuals aged 10 to 19 years increased from 0.34 per 1000 youths in 2001 to 0.67 per 1000 youths in 2017. The most substantial increases were observed in non-Hispanic White and non-Hispanic Black youths for type 1 diabetes and non-Hispanic Black and Hispanic youths for type 2 diabetes. These results suggested that the estimated prevalence of both type 1 and type 2 diabetes among US youths increased from 2001 to 2017. A limitation of this study was the relatively small proportion of study participants from some race and ethnicity groups, particularly American Indian and Asian or Pacific Islander, thus reducing the precision of the estimated prevalence for these groups and overall generalizability of the study findings.
Click to read the study in JAMA
Relevant Reading: Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009
In-Depth [cross-sectional study]: This observational, cross-sectional, multicenter study looked at individuals under 20 years with diabetes from 6 areas in the US (4 geographic areas, 1 health plan, and select American Indian reservations) for 2001, 2009, and 2017. Among individuals under 19 years, the prevalence of type 1 diabetes was 4,958 from 3.35 million youths in 2001, 6,672 from 3.46 million in 2009, and 7,759 from 3.61 million in 2017. Among patients aged 10 to 19 years, the prevalence of type 2 diabetes was 588 from 1.73 million in 2001, 814 from 1.85 million in 2009, and 1,230 from 1.85 million in 2017. For type 1 diabetes, the estimated prevalence per 1,000 under-19 youths increased significantly from 1.48 (95%CI, 1.44-1.52) in 2001 to 1.93 (95%CI, 1.88-1.98) in 2009 to 2.15 (95%CI, 2.10-2.20) in 2017, an absolute increase of 0.67 per 1000 youths (95%, CI, 0.64-0.70) and a 45.1% (95%CI, 40.0%-50.4%) relative increase over 16 years. For type 2 diabetes, the estimated prevalence per 1000 youths aged 10 to 19 years also increased significantly from 0.34 (95%CI, 0.31-0.37) in 2001 to 0.46 (95%CI, 0.43-0.49) in 2009 to 0.67 (95%CI, 0.63-0.70) in 2017, an absolute increase of 0.32 per 1000 youths (95%CI, 0.30-0.35) and a 95.3% (95%CI, 77.0%-115.4%) relative increase over 16 years. For type 1 diabetes, the most substantial increases were observed in non-Hispanic White (0.93 per 1000 youths [95%CI, 0.88-0.98]) and non-Hispanic Black (0.89 per 1000 youths [95%CI, 0.88-0.98]) youths. For type 2 diabetes, the most substantial increases were observed in non-Hispanic Black (0.85 per 1000 youths [95%CI, 0.74-0.97]) and Hispanic (0.57 per 1000 youths [95%CI, 0.51-0.64]) youths.
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