Diabetes has surged among US youth, decades-long study finds

Diabetes surged among American children, teens and adolescents to 2017, according to new federally-funded research spanning nearly 20 years finding a 45% increase in type 1 diagnoses, and a 95% growth in type 2 diagnoses.

"Increases in diabetes are always troubling – especially in youth. Rising rates of diabetes, particularly type 2 diabetes, which is preventable, has the potential to create a cascade of poor health outcomes," Dr. Giuseppina Imperatore, chief of the Surveillance, Epidemiology, Economics, and Statistics Branch in CDC’s Division of Diabetes Translation, said in a statement issued Tuesday. "Compared to people who develop diabetes in adulthood, youth are more likely to develop diabetes complications at an earlier age and are at higher risk of premature death."

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Findings published in JAMA on Tuesday indicated that Type 1 diabetes persists as the most common type of diabetes among U.S. youth. Results stemmed from an average of 3.5 million Americans under age 20 studied on a yearly basis from 2001 to 2017 across areas of California, Colorado, Ohio, South Carolina, Washington State, Arizona and Mexico. Results indicated significant increases in type 1 diabetes among Americans 19 years or younger, from 1.48 per 1,000 young people to 2.15 per 1,000 by 2017, or a 45% increase over 16 years, whereas the prevalence of type 2 diabetes among kids aged 10-19 increased from 0.34 per 1,000 youths to 0.67 per 1,000 youths, or a 95.3% increase over 16 years.

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Study authors noted no significant differences in the increases in diabetes prevalence across sexes.

The study found the largest increases in type 2 diabetes were among Black and Hispanic youth, with increases in the estimated prevalence of type 1 diabetes greatest among Black and White youths. Kids under age 9 with type 2 diabetes were excluded from the study due to small sample sizes.

Diabetes is a chronic health condition impacting how the body converts food into energy. According to the Centers for Disease Control and Prevention (CDC), "If you have diabetes, your body either doesn’t make enough insulin or can’t use the insulin it makes as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease."

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While there is no cure, diabetes patients can manage the disease through medication, insulin therapy, weight loss, a healthy diet and exercise. Most people who have diabetes have type 2 diabetes, which develops over many years and is typically diagnosed in adulthood, though increasing diagnoses are occurring earlier in life. Type 1 diabetes is believed to involve an autoimmune reaction that prevents the body from making insulin; type 1 patients comprise some 5%-10% of diabetes patients, and is usually diagnosed in childhood, requiring daily insulin.

The CDC notes diabetes is the seventh leading cause of death in the U.S., and in the last 20 years, the share of U.S. adults with diabetes diagnoses more than doubled.

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"More research is needed to better understand the underlying causes of the increases we’re seeing in type 1 and type 2 diabetes in U.S. youth," Jean Lawrence, lead author on the paper and director of the Diabetes Epidemiology Program, Division of Diabetes, Endocrinology, and Metabolic Diseases in the National Institute of Diabetes and Digestive and Kidney Diseases at the NIH, said in a statement. "Increasing prevalence of type 2 diabetes could be caused by rising rates of childhood obesity, in utero exposure to maternal obesity and diabetes, or increased diabetes screenings. The impact of diabetes on youth is concerning as it has the potential to negatively impact these youth as they age and could be an early indicator of the health of future generations."