Among youth in US, whites have highest incidence of diabetes

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Public release date: 26-Jun-2007

http://www.eurekalert.org/pub_releases/2007-06/jaaj-ayi062107.php

Contact: Caitlin Jenney

JAMA and Archives Journals

Among youth in US, whites have highest incidence of diabetes

Non-Hispanic white youth have the highest rate of diabetes of all

racial/ethnic groups for children in the U.S., with type 1 being the

predominant kind of diabetes among youth, according to a study in the

June 27 issue of JAMA, a theme issue on chronic diseases of children.

Dana Dabelea, M.D., Ph.D., of the University of Colorado Health Sciences

Center, Denver, presented the findings of the study at a JAMA media

briefing in New York.

Estimates of the incidence of type 1 diabetes mellitus (DM) show an

increase in incidence worldwide during the past two decades, according

to background information in the article. Type 2 DM has traditionally

been viewed as a disorder of adults, most likely persons who are

middle-age or elderly. But as the prevalence of obesity has increased in

recent decades, some studies have reported an increasing proportion of

youth with type 2 DM, especially among racial/ethnic minority

populations. However, data are limited regarding the types and incidence

of DM among U.S. youth of different racial/ethnic backgrounds.

Dr. Dabelea and colleagues with the SEARCH for Diabetes in Youth Study

Group identified the cases of DM among individuals younger than 20 years

in the U.S. to estimate the population incidence of type 1 and 2 DM

overall and by age and race/ethnicity. The study included 2,435

multi-ethnic youth with newly diagnosed DM in 2002 and 2003, from 10

locations in the U.S.

Overall, the incidence rate (per 100,000 person-years [the number of

individuals in the study times the number of years of follow-up per

person]) of DM was 24.3. The incidence rate was highest among 10- to

14-year-old youth (33.9), and slightly higher in females vs. males.

Overall, the highest incidence rates of DM were observed among

non-Hispanic white (26.1), African American (25.4), and American Indian

youth (25.0), with lower rates among Hispanic and Asian-Pacific Islander

youth.

For children age 0 to 4 years and 5 to 9 years, most DM was type 1,

regardless of race/ethnicity. The incidence of type 1 DM was highest

among non-Hispanic white children, and lowest among American Indian and

Asian-Pacific Islander children. Similarly, for older youth (10-14 years

and 15-19 years), the incidence of type 1 DM was highest among

non-Hispanic white children, followed by African American and Hispanic

youth.

“… taken together [with other studies], these data suggest that the

incidence of type 1 DM may be increasing in the United States,

consistent with worldwide trends,” the authors write. “We estimate that

the annual number of newly diagnosed youth with type 1 DM in the United

States is approximately 15,000.”

Overall, type 2 DM was relatively infrequent, but the highest rates were

documented among 15- to 19-year-old minority groups, including American

Indian youth, followed by African American, Asian-Pacific Islander, and

Hispanic youth. “Although the evidence of the presence of type 2 DM in

youth is still developing, it is consistent with the increasing

prevalence of type 2 DM in adults, and the increasing prevalence of

obesity in both adults and children.”

“The SEARCH study provides unique population-based data on the incidence

of DM among youth of various racial/ethnic backgrounds, according to DM

type. Continuing this surveillance effort will document temporal trends

in the incidence of DM among various racial/ethnic groups and accurately

assess the future health care burden of DM and its complications in the

U.S. pediatric and young adult population,” the researchers conclude.

(JAMA. 2007;297:2716-2724. Available pre-embargo to the media at

www.jamamedia.org)

Editor’s Note: Please see the article for additional information,

including other authors, author contributions and affiliations,

financial disclosures, funding and support, etc.

Editorial: Incidence of Diabetes in Children and Youth—Tracking a Moving

Target

In an accompanying editorial, B. Lipton, Ph.D., M.P.H., B.S.N.,

of the University of Chicago, comments on the findings of Dabelea and

colleagues.

“The SEARCH project adds some detail to the understanding of the

changing nature of diabetes risk in the United States. The authors have

ascertained cases in a range of settings, under the stringent privacy

regulations that have constrained much population-based research in the

United States recently. In particular, their group is well positioned to

examine geographic differences in diabetes risk among the diverse

locations represented in the SEARCH study.”

“As this and other research goes forward, it may be possible to develop

a better understanding of the interplay of autoimmunity with youth-onset

diabetes. There is an urgent need to go beyond studies such as this one

by implementing a coordinated approach to childhood diabetes

surveillance (i.e., mandated case-reporting). Only then can society

respond effectively to the serious and increasing challenge of diabetes

in youth.”

(JAMA. 2007;297:2760-2761. Available pre-embargo to the media at

www.jamamedia.org)

Editor’s Note: Please see the article for additional information,

including financial disclosures, funding and support, etc.

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