Rates of new type 1 and type 2 diabetes diagnoses are increasing among kids and teenagers in the US, and dramatically so among kids of color. That's the frightening takeaway from a study recently published in the New England Journal of Medicine.
The project, funded by the Centers for Disease Control and Prevention and the National Institutes of Health, claims to be the first study to estimate trends in youth diabetes rates by race. The team behind the SEARCH for Diabetes in Youth Study screened for both types among the under-20 age bracket at health centers in five states. It's worth noting that type 2 diabetes used to be referred to as "adult onset" because it took a long time to develop and was extremely rare in youth. But that name is no longer used since school-aged kids are developing it, too.
The researchers found that new cases of type 1 diabetes increased by about 1.8 percent each year from 2002 to 2012, while cases of type 2 increased even faster, by about 4.8 percent annually. That translates to a rate of 21.7 cases of type 1 per 100,000 kids in 2012, up from 19.5 cases per 100,000 in 2002. For type 2, cases increased from 9 per 100,000 to 12.5 per 100,000. (There are still way more kids with type 1 than type 2: This study identified 11,244 in the former group and 2,846 in the latter.)
New type 1 diabetes cases increased most sharply in Latinx kids, with a 4.2 percent annual increase. Cases among black kids increased by 2.2 percent a year, compared to 1.2 percent among white kids. There was no noteworthy increase among Asian/Pacific islander and Native Americans, but the authors note that they were unable to get a sample representative of all Native American youth in the US, so those stats shouldn't be generalized to the whole population. (Boys were slightly more likely than girls to develop type 1 diabetes: a 2.2 percent increase annually, versus 1.4 percent.)
As for type 2 diabetes, the Native American kids in the study had the biggest increase at 8.9 percent annually (but, again, take with a grain of salt) and Asian Americans/Pacific Islanders weren't far behind at 8.5 percent. Black kids had 6.3 percent more cases every year, compared to 3.1 percent in Latinx kids, and just 0.6 percent for white kids. Type 2 diabetes hit girls harder than boys with a 6.2-percent annual increase, compared to 3.7 for boys.
The authors note that disproportionate increases in obesity in Latinx girls and black boys during the study period may have contributed to type 2 diabetes; extra body fat affects how the body uses insulin, a hormone that helps turn sugar into energy. They're also concerned about the racial differences in type 1 diabetes diagnoses, which likely aren't explained by obesity rates.
Type 1 diabetes causes the pancreas to stop making insulin and cannot be prevented; doctors don't know exactly what causes it but they believe an environmental trigger could spur an immune system attack in people who are genetically predisposed to the disease. It's usually diagnosed in childhood and accounts for a sliver of the total diabetes population, about five to ten percent. Type 2 diabetes is a condition where the body doesn't make enough insulin or doesn't use it well and accounts for the vast majority of total diabetes cases. Regardless of the type, uncontrolled blood sugar levels can lead to complications including blindness, nerve damage, kidney failure, heart attacks, and stroke. The CDC says more than 76,000 people die from diabetes every year.
It's a bad sign that either type of diabetes is on the rise in kids and teens because it means they have to manage this condition for the rest of their lives, but it's extra bad that rates are not rising evenly among racial groups, meaning that the burden of disease will not be shared equally.
As Giuseppina Imperatore, an epidemiologist with the CDC, said in a release: "Because of the early age of onset and longer diabetes duration, youth are at risk for developing diabetes related complications at a younger age. This profoundly lessens their quality of life, shortens their life expectancy, and increases health care costs."
In March 2016, A Tribe Called Quest's Malik Taylor, aka Phife Dawg, died from complications of diabetes at age 45; he was diagnosed at age 20.