Diabetes in African American youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study

Abstract

Objective: To report the prevalence and incidence of type 1 and type 2 diabetes among African American youth and to describe demographic, clinical, and behavioral characteristics.

Research design and methods: Data from the SEARCH for Diabetes in Youth Study, a population-based, multicenter observational study of youth with clinically diagnosed diabetes aged 0-19 years, were used to estimate the prevalence for calendar year 2001 (692 cases) and incidence based on 748 African American case subjects diagnosed in 2002-2005. Characteristics of these youth were obtained during a research visit for 436 African American youth with type 1 diabetes and 212 African American youth with type 2 diabetes.

Results: Among African American youth aged 0-9 years, prevalence (per 1,000) of type 1 diabetes was 0.57 (95% CI 0.47-0.69) and for those aged 10-19 years 2.04 (1.85-2.26). Among African American youth aged 0-9 years, annual type 1 diabetes incidence (per 100,000) was 15.7 (13.7-17.9) and for those aged 10-19 years 15.7 (13.8-17.8). A1C was >or=9.5% among 50% of youth with type 1 diabetes aged >or=15 years. Across age-groups and sex, 44.7% of African American youth with type 1 diabetes were overweight or obese. Among African American youth aged 10-19 years, prevalence (per 1,000) of type 2 diabetes was 1.06 (0.93-1.22) and annual incidence (per 100,000) was 19.0 (16.9-21.3). About 60% of African American youth with type 2 diabetes had an annual household income of <$25,000. Among those aged >or=15 years, 27.5% had an A1C >or=9.5%, 22.5% had high blood pressure, and, across subgroups of age and sex, >90% were overweight or obese.

Conclusions: Type 1 diabetes presents a serious burden among African American youth aged <10 years, and African American adolescents are impacted substantially by both type 1 and type 2 diabetes.

Figure 1

Prevalence (2001) and incidence (2002–2005) of type 1 and type 2 diabetes among African American youth according to age and sex: the SEARCH study. □, male subjects; , female subjects.

Figure 2

Markers of socioeconomic status among African American youth with type 1 and type 2 diabetes: the SEARCH study. Less income is <$25,000 annual household income. Low education is less than high school diploma. Medicare/Medicade is insurance reported by participants from the four geographic-based sites only (health plan sites excluded).

Figure 3

Overweight and obesity among African American youth with type 1 and type 2 diabetes according to age and sex: the SEARCH study. *Difference in weight status between type 1 diabetic female and male subjects is significant (P < 0.01). Age represents age at time of SEARCH study visit. Weight categories are defined based on Centers for Disease Control and Prevention definitions of weight status. □, underweight/normal; , overweight; ▪, obese.