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Rates of Diabetes in Young People on the Rise

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Aug. 25, 2021 -- Rates of diabetes among young people in the United States rose significantly from 2001 to 2017, with cases of type 2 diabetes climbing most quickly among racial and ethnic minorities.

In people age 19 years or younger, rates of type 1 and type 2 diabetes increased 45.1% and 95.3%, respectively, Jean M. Lawrence, doctor of science, and colleagues at of the National Institute of Diabetes and Digestive and Kidney Diseases, found in a new study.

Understanding differences and trends in the rise of diabetes “is essential to describe the burden of disease and to estimate current and future resource needs,” Lawrence and colleagues wrote in JAMA.

The study, which includes data from individuals in six areas across the United States: Colorado, California, Ohio, South Carolina, Washington state, and Arizona/New Mexico (Indian Health Services). In the report, 3 years were evaluated: 2001, 2009, and 2017. For each year, about 3.5 million youths were included. Findings were reported in terms of diabetes type, race/ethnicity, age at diagnosis, and sex.

Rates of type 1 diabetes per 1,000 youths increased from 1.48 in 2001, to 1.93 in 2009, and finally 2.15 in 2017. Across the 16-year period, this represents an increase of of 45.1%. Prevalence increased most among non-Hispanic white people (0.93 per 1,000) and non-Hispanic Black (0.89 per 1,000) youths.

While type 2 diabetes was comparatively less common, rates increased to a greater degree, rising 95.3%. Increases were again greater among Black and Hispanic youth.

Lawrence and colleagues offered several possible factors driving these trends in type 2 diabetes.

“Changes in … risk factors appear to play a significant role,” they wrote, noting that, “Black and Mexican American teenagers experienced the greatest increase in prevalence of obesity/severe obesity from 1999 to 2018, which may contribute to race and ethnicity differences.”

Megan Kelsey, MD, associate professor of pediatric endocrinology, medical director of the bariatric surgery center at Children’s Hospital Colorado in Aurora, says the increased rates of type 2 diabetes are alarming, yet they pale in comparison with what’s been happening since the pandemic began.

“Individual institutions have reported anywhere between a 50% – which is basically what we’re seeing at our hospital – to a 300% increase in new diagnoses [of type 2 diabetes] in a single-year time period,” Kelsey says. “So what is reported [in the present study] doesn’t even get at what’s been going on over the past year and a half.”

Kelsey offered some ideas to possibly explain the surge in cases, including stress, weight gain caused by lack of physical activity and more access to food, and the possibility that the coronavirus may interfere with insulin production.

Type 2 diabetes is particularly concerning among young people, Kelsey noted, as it is more challenging to manage than adult-onset disease.

Young patients “also develop complications much sooner than you’d expect,” she added. “So we really need to understand why these rates are increasing, how we can identify kids at risk, and how we can better prevent it, so we aren’t stuck with a disease that’s really difficult to treat.”

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