Increasing Incidence of Type 1 Diabetes in Youth

Lipman, Terri H.; Katz, Lorraine E. Levitt; Ratcliffe, Sarah J.; Murphy, Kathryn; Aguilar, Alexandra; Rezvani, Iraj; Howe, Carol J.; Fadia, Shruti; Suarez, Elizabeth A.

doi:10.2337/dc12-0767

Cited by 104 publications

(81 citation statements)

References 30 publications

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“…(See Supplementary Fig. 4 (18), which may at least partially explain the increase in prevalence of type 1 diabetes seen in this study. Obesity is the most important risk factor for type 2 diabetes in youth, and the rise in pediatric obesity was accompanied by an increased prevalence of type 2 diabetes in children (19,20).…”

Section: Prevalence Of Diabetic Nephropathymentioning

confidence: 72%

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Prevalence of Diabetes and Diabetic Nephropathy in a Large U.S. Commercially Insured Pediatric Population, 2002–2013

Jick

Breitenstein

et al. 2015

Diabetes Care

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OBJECTIVE To estimate the prevalence of diabetes and diabetic nephropathy in a large population of U.S. commercially insured patients aged <18 years from 2002 to 2013. RESEARCH DESIGN AND METHODS Using the U.S. MarketScan Commercial Claims and Encounters Database, we identified 96,171 pediatric patients with diabetes and 3,161 pediatric patients with diabetic nephropathy during 2002–2013. We estimated prevalence of pediatric diabetes overall, by diabetes type, age, and sex, and prevalence of pediatric diabetic nephropathy overall, by age, sex, and diabetes type. RESULTS The annual prevalence of diabetes in the whole pediatric population increased from 1.86 to 2.82 per 1,000 during 2002–2013: 1.48 to 2.32 per 1,000 for type 1 diabetes and 0.38 to 0.67 per 1,000 for type 2 diabetes in 2002–2006 and then 0.56 to 0.49 per 1,000 thereafter. The annual prevalence of diabetic nephropathy in pediatric patients with diabetes increased from 1.16 to 3.44% for all cases and 0.83 to 2.32% for probable cases only in 2002–2013. Prevalence of diabetes and diabetic nephropathy was highest in patients aged 12 to <18 years. While prevalence of type 1 diabetes was higher in male than in female youth, prevalence of type 2 diabetes and diabetic nephropathy was higher in female than in male youth. There was no difference in prevalence of diabetic nephropathy by diabetes type. CONCLUSIONS The prevalence of diabetes and diabetic nephropathy increased in the U.S. MarketScan commercially insured pediatric population from 2002 to 2013. The prevalence of diabetes and diabetic nephropathy markedly increased starting at age 12 years.

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Section: Prevalence Of Diabetic Nephropathymentioning

confidence: 72%

“…Type 1 diabetes is an autoimmune disease. Although an increase was also seen in the incidence and prevalence of type 1 diabetes in children (8,(16)(17)(18), the causes for the increase are not clear.…”

Section: Prevalence Of Diabetic Nephropathymentioning

confidence: 99%

Prevalence of Diabetes and Diabetic Nephropathy in a Large U.S. Commercially Insured Pediatric Population, 2002–2013

Jick

Breitenstein

et al. 2015

Diabetes Care

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“…Considering the increasing life expectancy in T1DM 12 and the 1.5% to 3.0% annual increase in T1DM incidence, 13 determining the severity of, and risk factors for, WMH in patients with T1DM who are now aging deserves prompt investigation.…”

Section: Discussionmentioning

confidence: 99%

White matter hyperintensities in middle-aged adults with childhood-onset type 1 diabetes

Nunley¹,

Orchard²,

Aizenstein³

et al. 2015

Neurology

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Objective: Although microvascular complications are common in type 1 diabetes mellitus (T1DM), few studies have quantified the severity, risk factors, and implications of cerebral microvascular damage in these patients. As life expectancy in patients with T1DM increases, patients are exposed to age-and disease-related factors that may contribute to cerebral microvascular disease.Methods: Severity and volume of white matter hyperintensities (WMH) and infarcts were quantified in 97 middle-aged patients with childhood-onset T1DM (mean age and duration: 50 and 41 years, respectively) and 81 non-T1DM adults (mean age: 48 years), concurrent with cognitive and health-related measures.Results: Compared with non-T1DM participants, patients had more severe WMH (Fazekas scores 2 and 3 compared with Fazekas score 1, p , 0.0001) and slower information processing (digit symbol substitution, number correct: 65.7 6 10.9 and 54.9 6 13.6; pegboard, seconds: 66.0 6 9.9 and 88.5 6 34.2; both p , 0.0001) independent of age, education, or other factors. WMH were associated with slower information processing; adjusting for WMH attenuated the group differences in processing speed (13% for digit symbol, 11% for pegboard, both p # 0.05). Among patients, prevalent neuropathies and smoking tripled the odds of high WMH burden, independent of age or disease duration. Associations between measures of blood pressure or hyperglycemia and WMH were not significant. Conclusions:Clinically relevant WMH are evident earlier among middle-aged patients with childhood-onset T1DM and are related to the slower information processing frequently observed in T1DM. Brain imaging in patients with T1DM who have cognitive difficulties, especially those with neuropathies, may help uncover cerebral microvascular damage. Longitudinal studies are warranted to fully characterize WMH development, risk factors, and long-term effects on cognition. Patients with type 1 diabetes mellitus (T1DM) develop slower information processing speed earlier than adults without diabetes.1 In nondiabetic populations, slower information processing speed is strongly associated with white matter hyperintensities (WMH).2,3 Few studies, however, have characterized WMH in patients with T1DM. 4 Most of the knowledge about WMH comes from older populations without diabetes: WMH 5 are common in individuals older than 65 years, 6 with a prevalence ranging from 60% to 100%, 7 and are less frequent in middle-aged adults, with prevalence ranging from 0% to 50%. 8 Although they can remain silent, WMH predict greater incidence of stroke, dementia, disability, and death.2,9-11 In addition to older age, chronic exposure to hypertension and hyperglycemia are known risk factors for WMH in adults without diabetes, conditions that may predispose patients with T1DM to develop WMH. Considering the increasing life expectancy in T1DM 12 and the 1.5% to 3.0% annual increase in T1DM incidence, 13 determining the severity of, and risk factors for, WMH in patients with T1DM who are now aging deserves prompt...

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“…Improved methods to identify which at-risk individuals will progress to diabetes and the tempo of β cell destruction will be crucial to select subjects for future primary and secondary prevention trials (4)(5)(6). Data from T cell readouts, metabolomic profiles, serum analytes, and gene expression have the potential to contribute novel insights into mechanisms underlying disease progression (4,(7)(8)(9)(10)(11). In particular, gene expression profiling provides a global picture of cellular events under different physiological conditions.…”

Section: Introductionmentioning

confidence: 99%

A peripheral blood transcriptomic signature predicts autoantibody development in infants at risk of type 1 diabetes

Mehdi¹,

Hamilton‐Williams²,

Cristino³

et al. 2018

JCI Insight

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Increasing Incidence of Type 1 Diabetes in Youth

Cited by 104 publications

References 30 publications

Prevalence of Diabetes and Diabetic Nephropathy in a Large U.S. Commercially Insured Pediatric Population, 2002–2013

Prevalence of Diabetes and Diabetic Nephropathy in a Large U.S. Commercially Insured Pediatric Population, 2002–2013

White matter hyperintensities in middle-aged adults with childhood-onset type 1 diabetes

A peripheral blood transcriptomic signature predicts autoantibody development in infants at risk of type 1 diabetes

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