It’s not your imagination—diabetes rates among youth in the United States are rising.
A study published in 2017 on the diagnosis rates of diabetes of youth in the U.S. found that type 2 had increased approximately 5% from 2002 to 2012. It would be easy to associate the increase in type 2 with increases in obesity and decreases in exercise, but diagnosis rates of type 1 went up approximately 2% every year during the same time period. And the study noted that there was not a significant increase in in obesity rates overall. The study’s authors of the study see this as a significant linear increase in diabetes rates in American youth.
As of 2017, there were approximately 208,000 youth under 20 dealing with diagnosed diabetes. And while rates of type 1 and type 2 seem to be rising for all ethnicities, rates are rising faster among minority groups.
But why? Edwin A.M. Gale, of the Department of Diabetes and Metabolism at the University of Bristol, traces rates of diabetes incidence, mostly type 1, back further and notes that diabetes rates began to rise near the end of the 1900s in both Western countries and other parts of the world.
Some rise in diabetes rates were of course due to better diagnosis methods. Gale notes that until 1851, urine tasting was the gold standard for diagnosis, but after the invention of chemical tests, diagnosis rates understandably increased. In 1923 a urine glucose test could be purchased at many U.S. drugstores for only a penny, making diagnosis both more accessible and more reliable than urine-tasting.
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The invention of insulin in 1921 meant that more youth were able to receive treatment rather than pass away undiagnosed, and it also meant that doctors could keep better track of the number of youth with diabetes.
Gale says, “Clinical suspicion has always been the mainstay of diagnosis, even in the AutoAnalyzer era, and we should not assume that earlier generations of physicians, who relied almost totally on their clinical skills, were less gifted or motivated than ourselves.” And while studies before 1950 should be viewed with caution because they likely underestimate diabetes prevalence, there is a clear trend of increasing diabetes rates in the majority of populations studied until the 1980s. The case for rising diabetes rates since the 1950s shouldn’t be ignored. And now we have evidence that definitively demonstrates a rates in childhood diabetes rates since, at the very minimum, 2002.
But what does it mean?
The American Diabetes Association says that 0.24% of American youth under 20 have diabetes. But will rates keep rising until childhood diabetes is common, or even prevailing?
Gale doesn’t think so. He says that there is evidence to suggest that diagnosis rates first began to rise in populations where there was a higher prevalence of diabetes, and then rates leveled off at later stages. And populations where incidence was lower to begin with have experienced increased rates of diagnosis. Gale notes, “The relative rate of increase is inversely proportional to current incidence, suggesting a catch-up phenomenon.” That begs the questions, how long until we catch up? Will we eventually reach a plateau?