Type 1 Diabetes will rise

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The incidence of type 1 diabetes among very young children will double from

2005 levels in a little over a decade if present trends continue, a new

study shows.

The prediction is based on type 1 diabetes trends in Europe, but experts say

there is every reason to believe that the U.S. will see a similar dramatic

increase in the disease.

They are also convinced that environmental exposures are driving the

increase, but it is far from clear what those exposures are.

Once known as juvenile diabetes, type 1 diabetes is much less common than

type 2 diabetes, except among children and adolescents.

The most common age of diagnosis has been the early teen years, but

epidemiologist C. , PhD, of Ireland's Queen's

University, tells WebMD that the burden may be shifting toward younger

children.

" We are likely to see more children with severe diabetes complications

presenting at earlier ages if we fail to recognize and adequately treat

disease in very young patients, " he says.

In the latest issue of *The Lancet*, and colleagues concluded that

rates of type 1 diabetes among children and young teens are increasing

faster than previous predictions suggested.

and colleagues analyzed data from European registries, which

included information on more than 29,000 children with type 1 diabetes,

enrolled between 1989 and 2003.

They found that:

- The overall increase in incidence of type 1 diabetes was 3.9% per year.

- The increase was greatest among children under 5, who saw increases of

5.4% per year compared to an annual increase of 4.3% among children between

the ages of 5 and 9 and 2.9% among children between the ages of 10 and 14.

- If present trends continue, total cases of disease are projected to

rise by 70% by 2020 and rates among children under 5 will double.

*Reasons for Increase in Type 1 Diabetes*

Since the increases are occurring so quickly, it is likely that

environmental influences are driving the trend, says.

Researchers are examining a wide range of possible environmental triggers,

including early-life diet, viral infection, and even C-section delivery. But

they still have more questions than answers.

" Being born to an older mom and C-section birth seem to be associated with

slight increases in risk, but neither one of these is sufficient to explain

the increases we are seeing, " he says.

University of Colorado epidemiologist Dana Dabelea, MD, PhD, tells WebMD

that one of the key areas of interest is rapid early growth due to improved

early-life nutrition.

Dabelea is a co-investigator on the SEARCH for Diabetes in Youth Study,

which is following children with type 1 and type 2 diabetes in different

areas in the U.S. in an effort to better understand diabetes trends in

non-adults.

In 2007, Dabelea and colleagues reported higher-than-predicted rates of type

1 diabetes. The increase was most pronounced among non-Hispanic white

children.

In an editorial accompanying the new study, Dabelea called for more research

on type 1 and type 2 diabetes in children.

" It is imperative that efforts directed at surveillance of diabetes in young

people continue and expand, not only to understand its complex etiology, but

also because of the increasing public health importance, " she writes.

SOURCES:

, C. *The Lancet*, May 28; online edition.

C. , PhD, epidemiology research group, Queen's

University Belfast.

Dana Dabelea, MD, PhD, associate professor, department of epidemiology,

Colorado School of Public Health, University of Colorado, Denver.

Dabelea D. *The Journal of the American Medical Association*, June 27,

2007; vol 297: pp 2716-2724.

http://www.medscape.com/viewarticle/703479?src=mp & spon=9 & uac=121648MY

--

Ortiz, MS RD

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