Rates of both type 1 and type 2 diabetes have jumped significantly within the last decade, finds a new study published in the Journal of the American Medical Association.
The multi-university study included cases of type 1 diabetes among children 0 to 19 years old and type 2 diabetes among people 10 to 19 years old. Overall, the 21 percent and 30.5 percent increases indicated a dramatic rise in prevalence over the eight-year study period. Researchers can only speculate as to the cause of the trend; however, a large component, they suspect, is the additional problem of childhood obesity.
"Most likely [it] is the obesity epidemic, but also the long-term effects of diabetes and obesity during pregnancy, which have also increased over time," explained study leader Dr. Dana Dabelea, associate dean for faculty at the Colorado School of Public Health, to Health Day. "It also highlights the facts that all racial/ethnic groups are affected by both major forms of diabetes.”
Dabelea and her colleagues collected data as part of the SEARCH For Diabetes in Youth study, which combs through the nation’s diabetics to gain robust insight on the disease. Between 2001 and 2009, researchers found the prevalence of type 1 diabetes, among roughly 3.3 million people, rose from 1.48 per 1,000 people to 1.93. After adjusting for population, the team found an increase of 21 percent. Among a population roughly half the size, the prevalence of type 2 diabetes rose 30.5 percent. And as Dabelea points out, both forms affect various ethnic groups equally.
"Historically, type l diabetes has been considered a disease that affects primarily white youth; however, our findings highlight the increasing burden of type l diabetes experienced by youth of minority racial/ethnic groups as well," the authors wrote.
One of the principal concerns regarding this uptick is the parallel trend of childhood obesity. The Centers for Disease Control and Prevention report that childhood obesity has more than doubled in children and quadrupled in adolescents over the last 30 years. In 2012, more than one-third of children and adolescents were overweight or obese. For many of the children in the study, adulthood is only a few years away — at which point they are more likely to suffer from complications and face reproductive risks, “which may further increase diabetes in the next generation," argue the authors.
But childhood obesity isn’t the only arbitrating factor. Combined with the additional rise in pregnancy complications due to maternal obesity, type 1 diabetes is itself an autoimmune disease. Where type 2 diabetics cannot use the hormone insulin properly, type 1 diabetics don’t produce it at all. This prevents them from converting sugar and starches into energy, and the fact type 1 diabetes is on the rise suggests to researchers a separate concern.
"Whether it's an interaction between genetics and environment that's increasing autoimmunity — we really don't know," Dr. Robert Ratner, chief medical and scientific officer for the American Diabetes Association. "It's a major question that needs to be answered." Ratner also pointed out that the overall prevalence of diabetes is necessarily going to grow, because science is now keeping more people alive that previously would have died. Pediatric rates, however, are a separate concern, he says, especially as these children age into the general population burden.
“There is a need to pay more attention to the prevention of diabetes,” Ratner told Health Day, “because we are not going to be able to care for all of these people.”
Source: Dabelea D, Mayer-Davis E, Saydah S, et. al. Prevalence of Type 1 and Type 2 Diabetes Among Children and Adolescents From 2001 to 2009. JAMA. 2014.