Many faces of diabetes in American youth: The SEARCH for diabetes in youth study

February 27, 2009

WINSTON-SALEM, N.C. - New findings from the nation's largest study of diabetes in youth paint an alarming picture of disease on the rise among every racial and ethnic group studied. Five articles appearing in the March supplement of Diabetes Care provide a comprehensive picture of diabetes in children and adolescents from five ethnic and racial groups in the United States, including non-Hispanic whites, Hispanics, blacks, Asian/Pacific Islanders and American Indians/Navajo Nation. The articles describe important aspects of the epidemiologic, metabolic, behavioral and quality of care issues in youth with diabetes.

SEARCH, a multi-center study of patients diagnosed with diabetes before they were 20 years old, is the largest surveillance effort of youth with diabetes conducted in the United States to-date. The articles provide unique information about the burden of type 1 and type 2 diabetes in youth from public health and clinical perspectives.

"The incidence rate of type 1 diabetes among U.S. non-Hispanic white youth is today one of the highest in the world: one in about 4,200 youth develops type 1 diabetes annually," said Ronny A. Bell, Ph.D., an associate professor of epidemiology and prevention at Wake Forest University Baptist Medical Center and lead author of "Diabetes in non-Hispanic White Youth," one of the five articles in publication. "This rate is higher than all previously reported U.S. studies and many European studies. Type 2 diabetes is relatively rare in non-Hispanic white youth, but incidence rates are still several-fold higher than those reported by European countries."

"We found that type 1 diabetes is more common than type 2 diabetes in Hispanic American youth of all ages" said Jean Lawrence, Sc.D., a research scientist and epidemiologist in the Department of Research and Evaluation at Kaiser Permanente Southern California and lead author of "Diabetes in Hispanic American Youth." "However, in youth age 15-19 the incidence of type 2 diabetes is higher than that of type 1 diabetes in girls but not boys. We also found that over a third of the youth in this oldest age group with either type 1 or type 2 diabetes had poor glycemic control, which increases their risk for future diabetes-related complications."

"In addition to documenting appropriate concerns about type 2 diabetes in African-American youth, we found type 1 diabetes is also more common than we had expected," said SEARCH study chair Elizabeth Mayer-Davis, Ph.D., a professor in the Department of Nutrition at the University of North Carolina School of Public Health and lead author of "Diabetes in African-American Youth." Nearly all black youth with diabetes under age 10 have type 1 diabetes, and for black girls age 10 to 14 years old, the incidence of type 1 diabetes is essentially the same as for white girls. Most concerning, about 50 percent of black youth age 15 years or older have poorly controlled blood sugar, which is 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: one in about 8,200 youth develops type 2 diabetes annually. Targeted public health efforts to address obesity and prevent type 2 diabetes among Asian and Pacific Islanders are needed," said Lenna Liu, M.D., M.P.H., an associate professor in the Department of Pediatrics at Seattle Children's Hospital and lead author of "Diabetes in Asian and Pacific Islander Youth." "We also found that rates of type 1 diabetes in American-Asian/Pacific Islander children were higher than rates in Asia and the western Pacific region."

"Of all racial and ethnic groups in SEARCH, Navajo youth have the greatest risk of type 2 diabetes: one in 2,542 develop diabetes annually," said Dana Dabelea, M.D., Ph.D., an associate professor in the Department of Epidemiology at the University of Colorado Denver and lead author of "Diabetes in Navajo Youth." "In contrast, type 1 diabetes, although present, is relatively uncommon. We also found that many Navajo youth with diabetes have poor glycemic control and evidence of severe depression. Together with high prevalence of smoking, high-fat diets, sedentary lifestyles, and lower socioeconomic status, these findings may translate to an increased prevalence of cardiovascular disease as these youth mature."

"Diabetes is one of the most common chronic diseases in children and adolescents and its occurrence is rising. The need for effective interventions to prevent new cases of both type 1 and type 2 diabetes is urgent. At the same time, we need to assure that every child with diabetes receives the best available care that we know will prevent them from developing kidney failure, sight-threatening retinopathy or premature cardiovascular diseases," says Ann Albright, Ph.D., director of the Division of Diabetes Translation at the Center for Disease Control and Prevention (CDC).

"These findings, which show unexpectedly high rates of childhood diabetes, paint a sobering picture of the heavy burden of diabetes on our young people. The new SEARCH data fill an important gap in our knowledge and will help guide future research and target efforts to improve the prevention and treatment of diabetes and its complications," said Barbara Linder, M.D., Ph.D., senior advisor for childhood diabetes research at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), one of the National Institutes of Health.

Those who develop diabetes in childhood are at increased risk for complications due to the longer duration of the disease compared with persons who develop diabetes as adults. "Continuing this surveillance effort is essential to document the future burden of diabetes and its complications on our youth, their families and the health care system" said Bell, principal investigator at Wake Forest Baptist and director of its Maya Angelou Center for Health Equity.
-end-
The study was funded by the CDC's Division of Diabetes Translation and NIDDK. It involves clinical centers in six states. The states (and their respective lead researchers) are: California (Lawrence), Colorado (Dabelea, study vice-chairperson), Hawaii (Beatriz Rodriguez, M.D.), Ohio (Lawrence Dolan, M.D.), South Carolina (Mayer-Davis, study chairperson) and Washington (Catherine Pihoker, M.D.). The central laboratory for the study is the Northwest Lipid Research Laboratories in Seattle, Washington (Santica Marcovina, Ph.D., Sc.D.). The coordinating center is at the Division of Public Health Sciences at Wake Forest University School of Medicine (Bell).

Media Relations Contacts: Annette Porter, aporter@wfubmc.edu, 336-716-2416; Mark Wright, mwright@wfubmc.edu, 336-716-3382; or Bonnie Davis, bdavis@wfubmc.edu; (336) 716-4977.

Wake Forest University Baptist Medical Center (www.wfubmc.edu) is an academic health system comprised of North Carolina Baptist Hospital, Brenner Children's Hospital, Wake Forest University Physicians, and Wake Forest University Health Sciences, which operates the university's School of Medicine and Piedmont Triad Research Park. The system comprises 1,154 acute care, rehabilitation and long-term care beds and has been ranked as one of "America's Best Hospitals" by U.S. News & World Report since 1993. Wake Forest Baptist is ranked 32nd in the nation by America's Top Doctors for the number of its doctors considered best by their peers. The institution ranks in the top third in funding by the National Institutes of Health and fourth in the Southeast in revenues from its licensed intellectual property.

Wake Forest Baptist Medical Center

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.