ADA: Type 2 Diabetes' Reach Into Childhood Defined

DENVER, June 26 -- Type 2 diabetes is no longer the "adult-onset" disease it once was.

About 22% of children with diabetes in 2002 and 2003 were type 2, which was once considered quite rare in the age group, researchers found in the first American registry.

Particular minority groups have even higher proportions of type 2 among children with diabetes, reported Dana Dabelea, M.D., Ph.D., of the University of Colorado, and colleagues, in the June 27 Journal of the American Medical Association.

Among American Indian children, though, 86.2% of diabetes was type 2 while the rate was 69.7% among Asian and Pacific Islander youth, they wrote.

The large pediatric diabetes registry trial has finally put numbers to what clinicians suspected, commented David M. Nathan, M.D., of Harvard, while at the American Diabetes Association meeting in Chicago.

"We had a sense of all this before," he said. "There has been huge concern that type 2 diabetes, which is epidemic now in adults has also increased in young people."

But, the lack of a U.S. registry study has left clinicians "guessing to a great extent," he noted.

A few prior population-based studies had been done, but many included only American Indians.

So, the SEARCH for Diabetes in Youth study was done to look at prevalence and incidence of childhood diabetes across ethnicities in America.

It included more than 10 million person-years of observation in 2002 and 2003, representing 6.2% of the U.S. population younger than 20.

Cases of newly physician-diagnosed non-gestational diabetes were ascertained from population-based registries in Cincinnati, Colorado, South Carolina, and Washington State as well as four American Indian reservation-based health plans in Arizona and New Mexico, and Kaiser-Permanente health maintenance organizations in California and Hawaii.

The researchers found 2,561 newly diagnosed patients younger than 20 years in 2002 and 2003 for an overall incidence rate of 24.3 per 100,000 person-years.

The highest rate was among non-Hispanic white youth (26.1 per 100,000 person-years) followed by African Americans (25.4 per 100,000 person-years), and American Indians (25.0 per 100,000 person-years).

Lower rates were seen among Hispanic (20.2 per 100,000 person-years) and Asian or Pacific Islander children (16.7 per 100,000 person-years).

Of the cases found, 1,905 were type 1 diabetes, 530 were type 2 diabetes, and 126 were a secondary or unknown type. Nearly all diabetes was type 1 up to age nine regardless of race or ethnicity.

Among those 10 and older, type 2 became more common, particularly among minority populations.