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Shocking Increase in Adolescent Diabetes Complications

Diabetic nephropathy risk found on rise in 12- to 18-year-old patients.

Type 1 diabetes, a childhood disease plaguing many across the nation, has been the topic of discussion for many years.  Children and adolescents are experiencing complications from diabetes in both type 1 and type 2 before they reach adulthood.  According to the Centers for Disease Control and Prevention, obesity has doubled and quadrupled in both populations respectively over the last 30+ years, which in turn puts the population at risk for developing prediabetes and type 2 diabetes.  Researchers have found that in addition to childhood diabetes, diabetic nephropathy has become increasingly prevalent.

A study recently published in December 2015 highlighted the trend ranging from 2002 to 2013.  Using a US MarketScan claims database, 96,171 pediatric patients were found to have diabetes.  Of those patients, 3,161 children were diagnosed with diabetic nephropathy.  Researchers determined eligibility by using ICD-9 codes as well as medication NDC’s associated with patient claims processed.  If patients were less than 6 years of age they were excluded, due to the conclusion of diagnosed type 1 diabetes. Also if patients had genetic kidney diseases or comorbidities that could have caused kidney dysfunction they were excluded.

Of the pediatrics under the age of 18, claims were documented for chronic kidney disease of all stages, end stage renal disease, protein in the urine, renal dialysis, and diabetic nephropathy.  Patients from this pool were then used for analysis.  About 79% of the pediatric population were type 1 diabetics. Half of the type 1 patients were males and in the age range of 12 to 18, both at 53%.  Of the type 2 patients, 60% were females and the ages ranged from 12 to 18 years for onset.

Diabetes in general was found to have a high prevalence in the 12 to 18 population with an increase from 3.47 to 5.71 per 1,000 in the years studied with females as the majority.  Type 2 diabetes increased from 0.38 to 0.67 from 2002 to 2006, and decreased from 0.56 to 0.49 from 2007-2013 per 1,000.  Scientists declared that diabetic nephropathy increased with age with a prevalence range of 1.62% to 4.30%, while increasing from 1.16% to 3.44% in both types during the 11-year study.

It can be concluded that the chance of acquiring diabetic nephropathy increases from the age of 12 years to 18 years.  Diabetic nephropathy also develops in both type 1 and type 2 diabetes during the specified age range, but it is not a common condition in youth.  While the prevalence increased is still uncommon, it is something that should be monitored and further explored.

 

Practice Pearls:

  • Diabetic nephropathy increases from the age of 12 years to 18 years in the pediatric population.
  • Diabetic nephropathy develops in both type 1 and type 2 diabetes during the specified age range, but it is not a common condition in youth.
  • Diabetic nephropathy it is something that should be monitored and further explored in the pediatric population.

Li, Lin et al. “Prevalence Of Diabetes And Diabetic Nephropathy In A Large U.S. Commercially Insured Pediatric Population, 2002–2013”. Diabetes Care (2015): dc151710. Web. 17 Jan. 2016.

Emedicine.medscape.com,. “Diabetic Nephropathy: Background, Pathophysiology, Etiology”. N.p., 2016. Web. 17 Jan. 2016.

CDC.gov. “Obesity Prevention | Healthy Schools | CDC”. N.p., 2016. Web. 17 Jan. 2016.

Researched and prepared by Samantha Ferguson, Doctor of Pharmacy Candidate University Of Florida A&M College of Pharmacy, reviewed by Dave Joffe, BSPharm, CDE