Why Is Type 1 Diabetes Rising Among America's Youth?

New data shows that the incidence of Type 1 and Type 2 diabetes is growing among young Americans. But the rise of Type 1 remains mostly a mystery.
Author:
Publish date:
(Photo: capturelifeinaction/Flickr)

(Photo: capturelifeinaction/Flickr)

Like the popularity of sugary energy drinks with badass-looking labels, the prevalence of diabetes is rising fast among America's youth. And we can't be lured into blaming high-sugar diets for the entirety of the generation's diabetic epidemic.

Back in 2001, an average of 15 under-20-year-olds in every crowd of 10,000 preteens and teens had been diagnosed with Type 1 diabetes. Fast forward to 2009 and that number had jumped to 19. Prevalence of Type 2 diabetes rose among 10- to 19-year-olds during the same period to 4.6 out of every 10,000—up from 3.4 eight years earlier.*

That's according to an analysis of millions of medical records obtained from health care networks in five states and from some American Indian reservations. The fleeting variety of diabetes that expectant mothers sometimes develop was excluded from the results, which were published this week in the Journal of the American Medical Association.

So what's going wrong? Dana Dabelea, a professor at the University of Colorado-Denver, one of the study's co-authors, doesn't think the change was the result of improvements in medical diagnoses. "Diabetes in youth usually presents rather acutely," she says, so it's hard for a doctor to miss it for too long.

The increase in Type 2 diabetes, which is brought on among the vulnerable through unhealthy diets, could perhaps be explained away by the depressing stuff that we stuff into our mouths. "Most likely, this is the result of the obesity epidemic," Dabelea says. The disease develops as tissues become resistant to the insulin that helps regulate blood sugar levels.

But the rise in the prevalence of Type 1 diabetes is not so easy to explain. Type 1 diabetics are born into the disease, harboring a genetic predisposition which allows their immune cells to destroy the pancreatic cells that produce insulin. Most Type 1 diabetics develop symptoms in their youth, which is why the autoimmune disease is often called juvenile diabetes. But the onset can also arrive during adulthood. So perhaps the problem is that the onset of Type 1 diabetes is coming on earlier than used to be the case.

As you can see from the following chart, all types of young Americans seem to be affected by the increase in prevalence of Type 1 diabetes, regardless of gender or race, with the exception of American Indians.

diabetes-prevalence

(Chart: JAMA Pediatrics)

"It's likely that something has changed in our environment—something that's causing more youth to develop the disease, maybe at younger ages," Dabelea says.

Because diabetes is something you hold onto for life, an increase in diabetes rates among young Americans has repercussions for the health of Americans as we age. "These youth will already have had diabetes for a while when they become adults," Dabelea points out—something that she says will lead to "increased morbidity from chronic complications," along with increased health care costs.

Until we understand exactly what causes Type 1 diabetes, we'll likely remain in the dark about the cause of its rising prevalence.

*UPDATE — May 07, 2014: We originally stated that the prevalence of Type 2 diabetes among young people had risen to 46 out of every 10,000, up from 34 eight years earlier. Those numbers have been corrected to 4.6 and 3.4, respectively.

Related