Diabetes Dateline
Spring/Summer 2008
Largest, Most Comprehensive Study of its Kind Tracks Diabetes in U.S. Youth
Nearly 154,000 children in the United States have some form of diabetes, according to results of the SEARCH for Diabetes in Youth study—a decade-long examination of the disease and its trends in youth. The study has found that while type 2 diabetes is still rare among children younger than 10, the risk of developing the disease increases with age, especially among certain minority groups. Researchers will report on diabetes trends among U.S. youth in 2010.
Led by the U.S. Centers for Disease Control and Prevention (CDC) and co-sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the $22 million study resulted from a disturbing trend, first noticed about 20 years ago: formerly unheard of in children, type 2 diabetes was suddenly accounting for as much as 40 percent of childhood diabetes cases in some clinics.
“An alarm went off,” said Giuseppina Imperatore, M.D., Ph.D., the lead scientist for SEARCH at the CDC. “There was something going on, but we didn’t have good epidemiological data to tell if the trend was real or not because these studies were not population-based.”
SEARCH, which began in 2000, is the first multicenter population-based diabetes surveillance effort that uses standardized methods and includes all major U.S. racial/ethnic groups and all types of diabetes.
SEARCH uses surveillance databases maintained by networks of endocrinologists, hospitals, care providers, and health plans from six geographically distinct locations chosen to reflect the diverse U.S. population. These networks refer new diabetes cases to SEARCH for further evaluation. Volunteers enrolled in SEARCH complete a physical examination and detailed medical history questionnaire and donate blood and urine for biochemical and genetic analyses.
SEARCH study sites, selected to reflect U.S. diversity, are
- Kaiser Permanente Southern California, Pasadena
- University of Colorado Health Sciences Center, Denver
- Pacific Health Research Institute, Honolulu
- Children’s Hospital Medical Center, Cincinnati
- University of South Carolina School of Public Health, Columbia
- Children’s Hospital & Regional Medical Center, Seattle
So far, SEARCH data have led to nearly two dozen publications—most notably, reports on the prevalence and incidence of youth diabetes broken down by age and sex in five major races/ethnicities: non-Hispanic White, African American, Hispanic, Asian/Pacific Islander, and American Indian.
Prevalence of Diabetes in Youth
Based on a one-time count in 2001, SEARCH estimates approximately 154,000 diabetes cases among youth aged 0 to 19 years old, or 1.82 cases per 1,000 youth.
Among younger children, aged 0 to 9 years, the vast majority of cases are still type 1. Prevalence was highest among non-Hispanic White youth.
In children aged 10 to 19, the prevalence of type 2 diabetes increased; however, type 1 still accounted for the majority of cases among all racial/ethnic groups except American Indians, who had a higher prevalence of type 2 diabetes. The prevalence of all types of diabetes was highest among non-Hispanic White and African American youth.
Incidence of Diabetes in Youth
To establish youth diabetes trends, SEARCH is tracking new cases diagnosed from 2002 to 2009. Based on data for 2002 to 2003, the overall incidence of diabetes is approximately 24.3 new cases per 100,000 per year. Type 2 diabetes represented an increasingly greater percentage of youth diabetes cases as children’s ages increased—from 0 cases in the group aged 0 to 4 years to about half of all new cases—except among non-Hispanic Whites—in the group aged 15 to 19. Among youth aged 15 to 19 years, American Indian youth had the highest incidence of type 2 diabetes, whereas non-Hispanic Whites had the lowest.
Understanding Diabetes in Youth
In addition to tracking diabetes, SEARCH is increasing scientists’ understanding of diabetes and its related conditions to help find better strategies to prevent, diagnose, and effectively treat diabetes in youth. The study is identifying risk factors for diabetes complications, learning how youth diabetes progresses and how types 1 and 2 differ, and describing what kind of treatment children are getting.
More information about the SEARCH study, including a list of publications to date, is available at www.searchfordiabetes.org.
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NIH Publication No. 08–4562
August 2008
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