U.S. White Youths Have Highest Incidence of Type 1 Diabetes

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This article originally posted 03 July, 2007 and appeared in Issue 371

Non-Hispanic white youth have the highest rate of diabetes of all racial/ethnic groups for children in the U.S., with type 1 being the predominant kind of diabetes among youth.

Estimates of the incidence of type 1 diabetes mellitus (DM) show an increase in incidence worldwide during the past two decades. Type 2 DM has traditionally been viewed as a disorder of adults, most likely persons who are middle-age or elderly. But as the prevalence of obesity has increased in recent decades, some studies have reported an increasing proportion of youth with type 2 DM, especially among racial/ethnic minority populations. However, data are limited regarding the types and incidence of DM among U.S. youth of different racial/ethnic backgrounds.

Dr. Dabelea and colleagues with the SEARCH for Diabetes in Youth Study Group identified the cases of DM among individuals younger than 20 years in the U.S. to estimate the population incidence of type 1 and 2 DM overall and by age and race/ethnicity. The study included 2,435 multi-ethnic youth with newly diagnosed DM in 2002 and 2003, from 10 locations in the U.S.

Overall, the incidence rate (per 100,000 person-years [the number of individuals in the study times the number of years of follow-up per person]) of DM was 24.3. The incidence rate was highest among 10- to 14-year-old youth (33.9), and slightly higher in females vs. males. Overall, the highest incidence rates of DM were observed among non-Hispanic white (26.1), African American (25.4), and American Indian youth (25.0), with lower rates among Hispanic and Asian-Pacific Islander youth.

For children age 0 to 4 years and 5 to 9 years, most DM was type 1, regardless of race/ethnicity. The incidence of type 1 DM was highest among non-Hispanic white children, and lowest among American Indian and Asian-Pacific Islander children. Similarly, for older youth (10-14 years and 15-19 years), the incidence of type 1 DM was highest among non-Hispanic white children, followed by African American and Hispanic youth.

“… taken together [with other studies], these data suggest that the incidence of type 1 DM may be increasing in the United States, consistent with worldwide trends,” the authors write. “We estimate that the annual number of newly diagnosed youth with type 1 DM in the United States is approximately 15,000.”

Overall, type 2 DM was relatively infrequent, but the highest rates were documented among 15- to 19-year-old minority groups, including American Indian youth, followed by African American, Asian-Pacific Islander, and Hispanic youth. “Although the evidence of the presence of type 2 DM in youth is still developing, it is consistent with the increasing prevalence of type 2 DM in adults, and the increasing prevalence of obesity in both adults and children.”

“The SEARCH study provides unique population-based data on the incidence of DM among youth of various racial/ethnic backgrounds, according to DM type.
JAMA. 2007;297:2716-2724.

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