Unexpectedly high rates of childhood diabetes revealed by multi-center study

The findings are outlined in a series of papers in a supplement to the March issue of the journal Diabetes Care, which reports the results of the SEARCH for Diabetes in Youth study.

The SEARCH project is a multi-center study of diabetes in people under age 20 and the largest surveillance effort of youth with diabetes ever conducted in the U.S. It is funded by the Centers for Disease Control and Prevention’s Division of Diabetes Translation and the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases.

The study examined non-Hispanic white, Hispanic, African-American, Asian/Pacific Islander and Navajo youth and provided unique information about the clinical and public health burdens generated by the increasing number of young people with Type 1 and Type 2 diabetes.

Dr. Elizabeth Mayer-Davis

Elizabeth Mayer-Davis, PhD, professor of nutrition in the UNC Gillings School of Global Public Health and the UNC School of Medicine, was the national study chairperson and principal investigator on the study of African-American youth. She also was lead author of the supplement’s introduction and the article, “Diabetes in African-American Youth,” and contributed substantially to other articles in the journal supplement.

Mayer-Davis is also the American Diabetes Association’s vice president of health care and education.

Diabetes is a serious disease that affects the body’s ability to produce or respond properly to insulin, a hormone that allows blood glucose to enter cells and be used for energy. Because they have the disease for longer, people who develop diabetes in childhood have a higher risk of complications than people who develop it as adults.

The study’s findings include:

• Each year, 1 in 4,200 non-Hispanic white youths develops Type 1 diabetes. This rate is higher than all previously reported U.S. studies.
• More than one-third of Hispanic youth aged 15 to 19 has poor glycemic control, which increases risk for future diabetes-related complications.
• About 50 percent of African-American youth aged 15 years and older have poorly controlled blood sugar, a major risk factor for many long-term, serious complications including vision-threatening eye disease, kidney disease and heart disease.
• Asian and Pacific Islander youth, particularly adolescents, have a high risk of obesity and Type 2 diabetes, and the rates of Type 1 diabetes in this group were higher than rates in Asia and the western Pacific region.
• American Indian/Navajo Nation youth have the greatest risk of Type 2 diabetes of all the study groups; one in 2,542 Navajo youth develops diabetes every year. Navajo youth with diabetes also may be more vulnerable to cardiovascular disease as they mature because they tend to have poor glycemic control, suffer from depression, smoke, and have high-fat diets and sedentary lifestyles.

The study and journal articles highlight the tremendous impact of diabetes, particularly for minority youth, Mayer-Davis said.

“Type 1 diabetes in minority youth has not been recognized as a public health problem,” she said. “It is critical to recognize that Type 1 diabetes, requiring insulin for survival, presents real health and lifestyle challenges for these youth and their families.

“Type 2 diabetes also is of critical concern as a growing epidemic. All youth with diabetes face lifelong risks for chronic complications including heart disease, kidney disease and vision impairment or loss. Appropriate medical care and support for healthy lifestyles for these young people is critical to their long-term health and well-being,” she said.

In addition to Mayer-Davis, other principal investigators and authors include: Ronny Bell, PhD, professor of epidemiology and prevention at the Wake Forest University School of Medicine; Jean Lawrence, ScD, research scientist and epidemiologist in the department of research and evaluation at Kaiser Permanente Southern California, in Pasadena, Calif.; Lenna Liu, MD, associate professor in the department of pediatrics at Seattle Children’s Hospital, in Seattle, Wash.; and Dana Dabelea, MD, PhD, associate professor in the department of epidemiology at the Colorado School of Public Health, University of Colorado Denver.

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To learn more about the SEARCH study, visit www.searchfordiabetes.org.

To learn more from the American Diabetes Association, visit www.diabetes.org.

To read the set of articles in Diabetes Care titled “The Many Faces of Diabetes in American Youth,” visit http://care.diabetesjournals.org.

UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.