ESPEYB19 15. Editors’ Choice Diabetes (2 abstracts)
15.5. Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001-2017
Lawrence JM , Divers J , Isom S , Saydah S , Imperatore G , Pihoker C , Marcovina SM , Mayer-Davis EJ , Hamman RF , Dolan L , Dabelea D , Pettitt DJ , Liese AD & Group SfDiYS
JAMA. 2021;326(8):717-27. doi: 10.1001/jama.2021.11165.PubMed ID: 34427600
Brief summary: This large repeated cross-sectional study identified all individuals aged <20 years with physician-diagnosed diabetes in 6 areas in the US in 2001, 2009, and 2017. Over these 16 years, the prevalence of Type 1 diabetes (T1D) increased by 45% (95% CI, 40%–50%) and the prevalence of Type 2 diabetes (T2D) almost doubled (relative increase 95.3%; 95% CI, 77.0%–115.4%).
This comprehensive study quantifies the alarming rates of rise in both T1D and T2D. Data were collected from clinical centers in each area, and each survey year covered a mean estimated 3.47 million youths aged <20 years from 4 geographic areas, 1 health plan, and select American Indian reservations. The rise in T1D was more marked between 2001–2009 (+3.4% per year) than 2009–2017 (+1.4% per year), whereas the rise in T2D accelerated from 2001–2009 (+3.7% per year) to 2009–2017 (+4.8% per year). Furthermore, Black and Hispanic youths showed the greatest absolute increases in the prevalences of both T1D and T2D.
The authors hypothesize that secular changes in obesity and ethnic composition of the population contributed to the rise in T2D. They were puzzled by the rise in T1D, which they conjectured is due to infectious and mucosal exposures in the first 2 years. However, Paper 10.4 in this Yearbook identifies that not only T2D but also T1D risk is enhanced by childhood overweight and obesity (1).
These data are accompanied this year by similar highly concerning statistics showing that the incidence of Gestational Diabetes (GDM) rose by one third over 8 years, between 2011 to 2019 in the US (2). Together, these findings show that we are losing the battle not only with obesity, but also with its major glycaemic metabolic consequences.
References: 1. Richardson TG, et al. Childhood body size directly increases type 1 diabetes risk based on a lifecourse Mendelian randomization approach. Nat Commun. 2022 Apr 28;13(1):2337. 2. Shah NS, et al. Trends in Gestational Diabetes at First Live Birth by Race and Ethnicity in the US, 2011–2019. JAMA. 2021;326(7):660–669. doi: 10.1001/jama.2021.7217.
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ESPE Yearbook of Paediatric Endocrinology
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