Projections of Type 1 and Type 2 Diabetes Burden in the U.S. Population Aged <20 Years Through 2060: The SEARCH for Diabetes in Youth Study

Abstract

Objective: To project the prevalence and number of youths with diabetes and trends in racial and ethnic disparities in the U.S. through 2060.

Research design and methods: Based on a mathematical model and data from the SEARCH for Diabetes in Youth study for calendar years 2002-2017, we projected the future prevalence of type 1 and type 2 diabetes among youth aged <20 years while considering different scenarios of future trends in incidence.

Results: The number of youths with diabetes will increase from 213,000 (95% CI 209,000; 218,000) (type 1 diabetes 185,000, type 2 diabetes 28,000) in 2017 to 239,000 (95% CI 209,000; 282,000) (type 1 diabetes 191,000, type 2 diabetes 48,000) in 2060 if the incidence remains constant as observed in 2017. Corresponding relative increases were 3% (95% CI -9%; 21%) for type 1 diabetes and 69% (95% CI 43%; 109%) for type 2 diabetes. Assuming that increasing trends in incidence observed between 2002 and 2017 continue, the projected number of youths with diabetes will be 526,000 (95% CI 335,000; 893,000) (type 1 diabetes 306,000, type 2 diabetes 220,000). Corresponding relative increases would be 65% (95% CI 12%; 158%) for type 1 diabetes and 673% (95% CI 362%; 1,341%) for type 2 diabetes. In both scenarios, substantial widening of racial and ethnic disparities in type 2 diabetes prevalence are expected, with the highest prevalence among non-Hispanic Black youth.

Conclusions: The number of youths with diabetes in the U.S. is likely to substantially increase in future decades, which emphasizes the need for prevention to attenuate this trend.

Graphical abstract

Figure 1

Projected prevalence of (A) and number of youths with (B) diabetes aged <20 years in the U.S., 2017–2060. In the constant incidence scenario, prevalence was projected under the assumption that the incidence rate did not change between 2017 and 2060. In the increasing incidence scenario, prevalence was projected under the assumption that trends in incidence observed between 2002 and 2017 continued until 2060. Shaded areas indicate 95% CIs.

Figure 2

Projected racial and ethnic disparities in diabetes prevalence among youth aged <20 years in the U.S., 2017–2060. In the constant incidence scenario, prevalence was projected under the assumption that the incidence rate did not change between 2017 and 2060. In the increasing incidence scenario, prevalence was projected under the assumption that trends in incidence observed between 2002 and 2017 continued until 2060.