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Published on October 12, 2021

Childhood Types 1 and 2 diabetes rates spike

Children Diabetes

Rates of Type 1 and Type 2 diabetes in American children and teenagers have risen dramatically since 2001, leaving some experts perplexed as to why.

The rates for both types of diabetes in this age group shot up during a 16-year period ending in 2017, according to a recent research report published in JAMA.

Given the prevalence of excess weight and obesity among Americans, including children, the startling rise in Type 2 diabetes isn’t surprising, said Evan M. Klass, MD, FACP, of the Endocrine Center of Cape Cod at Cape Cod Healthcare’s Fontaine Outpatient Center in Harwich. But, the rise in Type 1 diabetes “is a headscratcher.”

The number of diagnosed cases of Type 1 diabetes rose 45 percent, from 148 to 215 cases per 100,000 for youth ages newborn to 19. The number of Type 2 cases nearly doubled, increasing 95 percent from 34 to 67 per 100,000 for youth ages 10-19, according to a statement on the report by the Centers for Disease Control and Prevention. Work on the report was conducted by researchers at several institutions who examined information on 3.47 million young people from six regions in the country.

The report in JAMA drew data from the SEARCH for Diabetes in Youth study, which is funded by the CDC and the NIH. The report’s lead author, Jean M. Lawrence, works as the director of the Diabetes Epidemiology Program in the Division of Diabetes, Endocrinology, and Metabolic Diseases of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD).

In the CDC statement on the article, Lawrence wrote that factors responsible for the upswing in Type 2 diabetes among youth might be:

  • Increases in childhood obesity.
  • Effects of obesity and diabetes of pregnant mothers on their unborn children.
  • More health screenings for diabetes.

To better grasp why the dramatic rise occurred in both Type 1 and Type 2 diabetes among young children and teens, more research must be done, Lawrence added.

“The impact of diabetes on youth is concerning, as it has the potential to negatively impact these youth as they age and could be an early indicator of the health of future generations,” she wrote.

Type 1 and Type 2 Diabetes

Both forms of diabetes describe a condition where your blood sugar (glucose) level stays too high. If levels remain high, you’re at risk of cardiovascular-related problems, such as stroke, kidney disease and heart disease, as well as problems with your nerves, eyes, teeth and feet, according to the NIDDKD, which is part of the National Institutes of Health (NIH).

While the condition of excess blood sugar is the same for both Types 1 and 2 diabetes, “these are two different diseases,” Dr. Klass said.

The more common one, Type 2, does run in families, but it is preventable through diet and exercise, unlike Type 1, he said.

Currently, there is nothing parents can do to prevent their children from developing Type 1 diabetes, he said.

According to the CDC, people with Type 1 diabetes don’t produce enough or any of the hormone insulin from their pancreas. Insulin helps glucose enter the body’s cells and keeps blood sugar levels in a healthy range. An estimated 5-10 percent of people with diabetes have Type 1.

An autoimmune reaction, in which the body attacks the insulin-making cells in the pancreas, may be the cause of Type 1 diabetes, and exposure to environmental factors such as viruses may play a role.

Some people are genetically more likely to develop Type 1 diabetes but having those genes doesn’t guarantee a person will get the disease, Dr. Klass said. Type 1 is more common among white Americans, though the article in JAMA reported similar increases for both non-Hispanic whites and non-Hispanic Blacks 19 and younger.

The disease is not caused by poor diet, but healthy diet and exercise can help keep it in check. People with Type 1 diabetes must take injectable insulin to maintain their health.

People with Type 2 diabetes have insulin resistance – their body’s cells no longer respond as they should to insulin, so their pancreas makes more insulin, according to the CDC. As time goes on, the pancreas can’t make enough insulin to maintain normal blood sugar levels.

A family history of the disease and genetics can increase your odds of developing Type 2 diabetes, according to the NIDDKD. Being overweight or obese contributes to the likelihood of developing Type 2 diabetes.

The disease may be treatable with just diet and exercise or may also require insulin injections or an insulin pump. About 90-95 percent of the nation’s 34 million people with diabetes have Type 2. The report in JAMA reported the largest increases were among non-Hispanic Blacks and Hispanics 19 and younger. Black and Native American youth have the highest incidence of Type 2 diabetes.

Type 1 diabetes used to be called juvenile onset, because it typically arises in children and young adults, but it can occur in older adults, too. Type 2 used to be termed adult-onset, because it usually strikes people 45 and older, but now it’s becoming more common among young adults and children.

“We’ve abandoned those terms,” Dr. Klass said, noting that age alone as a diagnostic guideline can be misleading.

“Some people who had been classified as having Type 2 actually have Type 1.”

Childhood Obesity and the Future

“Childhood overweight and obesity are skyrocketing,” Dr. Klass said. “It’s a terrible, terrible problem.”

He urged parents to work with their pediatricians on ways to keep their children active and eating a healthy diet to avoid developing Type 2 diabetes, which he called “the gateway disease” to other health problems. Dr. Klass noted he doesn’t treat patients under age 18. He also said that technological advances, including innovative glucose monitors and insulin pumps, have made maintenance of Type 1 diabetes easier for patients.

Using the new tools, it is much easier for diabetic children to participate in all activities,” he said.

Dr. Klass predicted researchers will pore over the study’s data on the reported rise in Type 1 diabetes “to tease out any clues as to the explanation for the rising incidence.”