Philadelphia, PA-The first analysis of diabetes trends among American youth reveals that the prevalence of both type 1 and type 2 increased among young people substantially over the past decade. Researchers also found that complications such as nerve damage are already emerging in young people, raising concerns about the long-term health consequences for this and subsequent generations if the trend is not reversed, as reported at the American Diabetes Association’s 72nd Scientific Sessions®.
“Type 2, once known as ‘adult onset’ diabetes, is increasingly being diagnosed in young people,” said Giuseppina Imperatore, MD, PhD, Medical Epidemiologist with the Division of Diabetes Translation at the Centers for Disease Control and Prevention in Atlanta. “We’ve known this was happening for a while, but now we have data that tell us just how big a problem it has become. Additionally, worldwide, the number of youth who are being diagnosed with type 1 diabetes has been growing at an annual rate of about 3 percent. Our preliminary data indicate that this is the case among U.S. youth too. This is of grave concern, because these youth will live with diabetes most of their lives and may develop diabetes-related complications, such as heart and kidney disease, nerve damage and vision problems, at a much younger age. In fact, preliminary data suggest that complications may already be developing in this generation.”
The SEARCH for Diabetes in Youth study, funded by the Centers for Disease Control and Prevention and the National Institutes of Health, is assessing diabetes burden in children and youth younger than 20 years in five geographically dispersed populations that encompass the ethnic diversity of the United States. SEARCH investigators found that, overall, the prevalence of type 2 diabetes had increased 21 percent among American youth from 2001-2009, while type 1 diabetes rose 23 percent. The data suggest that there were nearly 189,000 Americans under the age of 20 with diabetes; of those, 168,000 had type 1 and more than 19,000 had type 2.
Preliminary findings from SEARCH presented during the scientific sessions also indicate the following:
• Children and adolescents with diabetes are not only at risk for complications such as peripheral neuropathy (nerve damage), many already show measurable signs of it. This could increase their future risk of lower limb amputations.
• Youth with type 2 diabetes, are more likely to have protein in the urine than youth with type 1, suggesting they may have a greater risk for kidney disease later in life.
• A pilot study, which looked at a subset of youth with type 1 and type 2 diabetes, found early indications of cardiovascular autonomic neuropathy (damage to the nerve system regulating the heart and its vessels), suggesting that these youth are at increased risk for future cardiovascular disease.
• Researchers also found that youth with diabetes who watched television for three or more hours per day had higher A1C and triglyceride levels than those who watched less television. Other lipids, such as cholesterol, did not appear to be affected by duration of television viewing.
The study showed that the proportion of youth with type 2 diabetes was highest among American Indian and non-Hispanic black youth, and in these groups it did not change over time. The proportion of Hispanic and non-Hispanic white youth with type 2 diabetes was lower, but it increased over time. A longer study period is needed to fully quantify these trends in all racial groups. Dana Dabelea, MD, PhD, Professor of Epidemiology and Pediatrics at the University of Colorado Denver noted that the risk of early-onset type 2 diabetes is heavily impacted by exposure to maternal diabetes or obesity in the womb. “The vicious cycle of obesity creates a transgenerational problem,” she said, “as the offspring of women who are obese or who have type 2 diabetes during pregnancy are more likely to develop diabetes early in life.”
“This research reinforces the need to ensure that young people with diabetes are getting more exercise, making healthier food choices and maintaining healthier weights,” said Elizabeth Mayer-Davis, MSPH, PhD, RD, Professor at the University of North Carolina and American Diabetes Association, Immediate Past-President, Health Care & Education.
Type 1 diabetes, shown in previous studies of European and worldwide registries to be on the rise in recent years, is not believed to be impacted by lifestyle in the same way as type 2. The reasons for its rise are yet unknown; however, researchers are investigating several hypotheses. One theory is that children and infants in contemporary environments are less exposed to viruses and bacteria that help the immune system mature, increasing their subsequent risk for type 1. Other hypotheses suggest that changes in the environment encourage kids to grow faster and gain more weight early in life which overloads the beta cells and triggers an autoimmune attack. Others are looking at changes in the diet of infants and when foods are introduced. However, it is not yet known why type 1 is increasing.
Press Conference: Saturday, June 9, 1 p.m.
The American Diabetes Association is leading the fight to Stop Diabetes and its deadly consequences and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, our mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit www.diabetes.org. Information from both these sources is available in English and Spanish.