Type 1 Diabetes on the Rise in Children

From the WebMD Archives

Dec. 17, 2014 -- More children in the U.S. are getting type 1 diabetes, according to new research.

A recent study by Jean Lawrence, ScD, MPH, found a large rise in the disease among non-Hispanic white children.

From 2002 to 2009, the number of kids with type 1 diabetes rose from 24 per 100,000 to 27 per 100,000. The most pronounced increase was in children 5 to 9 years old, says Lawrence. She's a research scientist at Kaiser Permanente Southern California's Department of Research & Evaluation.

Other studies have shown numbers rising among other racial groups in the U.S., and in children in Europe as well, she says.

Although Lawrence’s study didn’t examine the causes for the increase, most researchers agree there is no single cause.

"Like most other diseases, it's a combination of genes and our environment," says Jessica Dunne, PhD. She's the director and program lead for the Juvenile Diabetes Research Foundation's Prevention Program.

In type 1 diabetes, the body makes no or little insulin, the hormone crucial to allow sugar to get into cells for energy. It's most often diagnosed in childhood.

Long-term complications are similar to those with type 2 diabetes. They can include heart disease and damage to nerves, the kidneys, eyes, and feet, among other problems.

Genes and Type 1 Diabetes

For kids, in general, the chance of getting type 1 by age 18 is about 1 in 300. Experts know that someone with an immediate relative, such as a parent, sibling, son, or daughter, with type 1 diabetes is at 10 to 20 times' greater risk of getting it themselves.

Genes alone don’t cause type 1, but some genes can raise a person’s risk of getting it, Dunne says.

Lawrence says these genetic “triggers” may push a susceptible person into developing diabetes.

But nobody has identified the triggers. “If we could … that would be a key target for prevention," she says.

Environment's Role

Geography has long been suspected as a factor in type 1 diabetes, with higher rates found among those who live farthest from the equator. Finland and Sardinia have the most diagnoses of the disease.

Continued

Researchers are studying other possible causes as well. Among them:

  • Enteroviruses. These common viruses affect many people, and some experts have suggested that an unborn baby's exposure to them may even trigger the diabetes. Or, the infection with the virus might trigger the immune system to make proteins that incorrectly attack the pancreas, where insulin is made.
  • Hygiene theory. Our zest for cleanliness may lessen our exposure to infections. Some experts say that results in a change in the friendly gut bacteria that helps regulate the immune system. This can lead to a ''bored'' immune system that begins to attack itself. ''The gut plays a large role in the shaping of the immune system," Dunne says. It seems that changes in a person's unique collection of gut bacteria sometimes precede the development of type 1 diabetes, but experts aren't sure why, she says.
  • "Accelerator hypothesis." This idea suggests that over-nutrition or over-feeding in childhood leads to insulin resistance, raising the risk of diabetes.
  • Pregnancy factors. Experts have found that the risk of type 1 is slightly higher if a baby’s birth weight is higher or if the mother is older.

"I think there might be something environmental that might be changing over the years, and might be making all the susceptible people develop it," says Luis Gonzalez-Mendoza, MD. He's the director of pediatric endocrinology at Miami Children's Hospital.

What Can Parents Do?

The best parents can do, experts agree, is look out for early symptoms.

The earlier type 1 diabetes is diagnosed, the better.

Gonzalez-Mendoza tells parents to watch for symptoms such as frequent peeing, drinking lots of fluids, and loss of weight without trying. If any of these happen, parents should contact their child's pediatrician, he says.

WebMD Health News Reviewed by Arefa Cassoobhoy, MD, MPH and Hansa D. Bhargava, MD on December 17, 2014

Sources

SOURCES:

Jean Lawrence, ScD, MPH, research scientist, Kaiser Permanente Southern California Department of Research & Evaluation.

Luis Gonzalez-Mendoza, MD, director of pediatric endocrinology, Miami Children's Hospital.

Jessica Dunne, PhD, director and program lead, Juvenile Diabetes Research Foundation Prevention Program.

Lawrence, J. Diabetes, 2014.

Joslin Diabetes Center: "Genetics & Diabetes: What's Your Risk?"

Genetics Home Reference: "What is type 1 diabetes?"

Diapedia: "Type 1 diabetes mellitus—environmental factors."

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