Posted 10/02/2006

Report reveals that one in 523 U.S. children, teens has diabetes

In the nation's first study to examine the prevalence of type 1 and type 2 diabetes in youth of all major ethnic groups, researchers have found that about one in every 523 children and adolescents in the United States has diabetes.

The results of the study, called "SEARCH for Diabetes in Youth," appear in the October issue of Pediatrics.  Dr. Angela Liese, a researcher at the University of South Carolina's Arnold School of Public Health, is the lead author on the report, which describes the frequency -- or prevalence -- of diabetes.  The study will be the benchmark for future research on diabetes in youth.

"This study addresses an important gap in our knowledge, providing national estimates on the prevalence of type 1 and type 2 diabetes in children," said Dr. Judith Fradkin, Director of the Division of Diabetes, Endocrinology and Metabolic Diseases at the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK).

Liese said the prevalence of diabetes in youth under the age of 20 - 1.82 per thousand - is remarkably similar to a 1999 report of diabetes cases in Richland and Lexington counties in South Carolina.   "We need to be concerned about the burden of pediatric diabetes in South Carolina, as well as nationwide," Liese said.

Diabetes severely affects quality of life for these youth, has a major impact on their families and has a significant public-health impact, the investigators said in the report.   "Children and teens diagnosed with diabetes before 20 years of age have a markedly lower life expectancy than people who don't have diabetes," they wrote in Pediatrics.

SEARCH is the largest effort to date to document diabetes among U.S. youth under the age of 20, said Dr. Ronny A. Bell, associate professor of Epidemiology and Prevention at Wake Forest University School of Medicine, and a SEARCH co-investigator.  The SEARCH study estimated about 154,000 of roughly 81 million children and adolescents nationwide had diabetes in 2001, the year that the data was collected.  The number of youth with diabetes varies across major U.S. racial and ethnic groups and across age groups.

Among the study's findings:

• In children, from infants to age nine, non-Hispanic white children had the highest rate (about 1 in every 1,000 children).  In this age group -- across all racial and ethnic groups -- physician-diagnosed type 1 diabetes was the most common form of diabetes.

 • The study found that type 2 diabetes was extremely rare in children under 10 years of age of all races.

• Among adolescents and young adults, black and non-Hispanic white youth had the highest overall burden of diabetes (about 1 in every 315), and Asian/Pacific Islanders had the lowest (about 1  in 746).

• Type 1 diabetes was the most common form of diabetes in all racial/ethnic groups, except in American Indian youth.

• Type 2 diabetes was found in all racial and ethnic groups in youth ages 10 to 19. American Indian youth have the highest rate of type 2 diabetes: 76 percent of diabetes cases in these youth are type 2. Type 2 diabetes represents only 6 percent of the cases of diabetes in non-Hispanic whites, 33 percent in blacks and 40 percent in Asian/Pacific Islanders.

The study was funded by the U.S. Centers for Disease Control and Prevention and the NIDDK and involved clinical centers in California, Colorado, Hawaii, Ohio, South Carolina and Washington.  The central laboratory for the study is the Northwest Lipid Research Laboratories in Seattle, Wash.  The coordinating center is at the Wake Forest University School of Medicine.

"This important study has been extremely challenging because of the great difficulty of accurately finding all the cases of diabetes in this age group," said Dr. Michael Engelgau, acting director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention.

"This information will be critical to understanding this disease in children, which will lead to actions to better control it and to minimize its effects on our younger generation," he said.

Liese said SEARCH investigators will continue to track diabetes cases in all of the groups over the next few years.  "Increasing obesity in children began in the late 1980s and early 1990s, and people have speculated that the increase in obesity is associated with an increased risk of type 2 diabetes in youth," she said.   

According to the study investigators, diabetes is one of the leading chronic diseases in childhood and adolescence.