Trends in incidence of youth-onset type 1 and type 2 diabetes in the USA, 2002-18: results from the population-based SEARCH for Diabetes in Youth study.
Level 3 - non-randomized controlled study
Prospective population-based multi-center surveillance registry over a 17-year period
PubMed 36868256 · doi:10.1016/S2213-8587(23)00025-6
What was done
The SEARCH for Diabetes in Youth study tracked physician-diagnosed type 1 diabetes (ages 0–19 years) and type 2 diabetes (ages 10–19 years) at five US centers from 2002 to 2018. Denominators for populations at risk were determined using census and health plan member counts. Generalized autoregressive moving average models analyzed incidence trends by age, sex, race/ethnicity, geographic region, and seasonality.
What was found
Across 85 million person-years, 18,169 youth with type 1 diabetes were identified; across 44 million person-years, 5,293 youth with type 2 diabetes were identified. In 2017–2018, annual incidence was 22.2 per 100,000 for type 1 diabetes and 17.9 per 100,000 for type 2 diabetes. Incidence grew annually by a linear effect of 2.02% (95% CI 1.54–2.49) for type 1 diabetes and 5.31% (95% CI 4.46–6.17) for type 2 diabetes. Increases were greater among racial and ethnic minority groups, including non-Hispanic Black and Hispanic youth. Peak diagnosis age was 10 years (95% CI 8–11) for type 1 diabetes and 16 years (95% CI 16–17) for type 2 diabetes. Seasonality was significant, peaking in January for type 1 (p=0.0062) and in August for type 2 diabetes (p=0.0006).
Why it matters
This 17-year surveillance documents sharp, continuous increases in youth diabetes incidence—especially type 2 diabetes among minority populations—foreshadowing a higher future burden of early diabetic complications and clinical care demands.
Limits
The study is restricted to five geographic regions in the US, which may not capture all national demographic variations. Case identification depended on clinical diagnoses and denominator estimates from census or health plan data, and the abstract does not assess underlying causal mechanisms or socioeconomic confounding factors.
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- context One out of every three new diabetes diagnoses in pediatric patients is type 2 diabetes.