Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017

Abstract

Importance: Changes in the prevalence of youth-onset diabetes have previously been observed.

Objective: To estimate changes in prevalence of type 1 and type 2 diabetes in youths in the US from 2001 to 2017.

Design, setting, and participants: In this cross-sectional observational study, individuals younger than 20 years with physician-diagnosed diabetes were enumerated from 6 areas in the US (4 geographic areas, 1 health plan, and select American Indian reservations) for 2001, 2009, and 2017.

Exposures: Calendar year.

Main outcomes and measures: Estimated prevalence of physician-diagnosed type 1 and type 2 diabetes overall and by race and ethnicity, age, and sex.

Results: Among youths 19 years or younger, 4958 of 3.35 million had type 1 diabetes in 2001, 6672 of 3.46 million had type 1 diabetes in 2009, and 7759 of 3.61 million had type 1 diabetes in 2017; among those aged 10 to 19 years, 588 of 1.73 million had type 2 diabetes in 2001, 814 of 1.85 million had type 2 diabetes in 2009, and 1230 of 1.85 million had type 2 diabetes in 2017. The estimated type 1 diabetes prevalence per 1000 youths for those 19 years or younger increased significantly from 1.48 (95% CI, 1.44-1.52) in 2001 to 1.93 (95% CI, 1.88-1.98) in 2009 to 2.15 (95% CI, 2.10-2.20) in 2017, an absolute increase of 0.67 per 1000 youths (95%, CI, 0.64-0.70) and a 45.1% (95% CI, 40.0%-50.4%) relative increase over 16 years. The greatest absolute increases were observed among non-Hispanic White (0.93 per 1000 youths [95% CI, 0.88-0.98]) and non-Hispanic Black (0.89 per 1000 youths [95% CI, 0.88-0.98]) youths. The estimated type 2 diabetes prevalence per 1000 youths aged 10 to 19 years increased significantly from 0.34 (95% CI, 0.31-0.37) in 2001 to 0.46 (95% CI, 0.43-0.49) in 2009 to 0.67 (95% CI, 0.63-0.70) in 2017, an absolute increase of 0.32 per 1000 youths (95% CI, 0.30-0.35) and a 95.3% (95% CI, 77.0%-115.4%) relative increase over 16 years. The greatest absolute increases were observed among non-Hispanic Black (0.85 per 1000 youths [95% CI, 0.74-0.97]) and Hispanic (0.57 per 1000 youths [95% CI, 0.51-0.64]) youths.

Conclusions and relevance: In 6 areas of the US from 2001 to 2017, the estimated prevalence of diabetes among children and adolescents increased for both type 1 and type 2 diabetes.

Figure 1.. Estimated Prevalence of Type 1 Diabetes by Race and Ethnicity, Age, and Sex for 2001, 2009, and 2017

The number for each row is the mean number of youths with diabetes by sex within the race and ethnicity group across the 3 prevalence years. The number for each column is the mean number of youths with diabetes in the specific age group across the 3 prevalence years. The numbers for each group stratified by race and ethnicity, sex, and age group are shown in eTable 1 in the Supplement. The Hispanic category includes all Hispanic individuals regardless of race (American Indian, Asian or Pacific Islander, Black, or White). All race categories include only individuals who are not Hispanic.

Figure 2.. Estimated Prevalence of Type 2 Diabetes by Race and Ethnicity, Age, and Sex for 2001, 2009, and 2017

The number for each row is the mean number of youths with diabetes by sex within the race and ethnicity group across the 3 prevalence years. The number for each column is the mean number of youths with diabetes in the specific age group across the 3 prevalence years. The numbers for each group stratified by race and ethnicity, sex, and age group are shown in eTable 2 in the Supplement. The Hispanic category includes all Hispanic individuals regardless of race (American Indian, Asian or Pacific Islander, Black, or White). All race categories include only individuals who are not Hispanic.