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Rate of children dependent upon insulin soaring reports new study

Robin Wulffson MD's picture
type 1 diabetes, increase, children, insulin, ethnic disparity

The current obesity epidemic is spurring the rising rate of type 2 diabetes in many regions of the globe; however, a new study has found an alarming increase in the rate of type 1 (insulin dependent) diabetes among children in Philadelphia, paralleling increases throughout the US and Europe. In addition, ethnic disparities in the rate exist. The findings were presented online on January 30 in the journal Diabetes Care by researchers affiliated with the University of Pennsylvania.

The objective of the study was to describe the incidence of type 1 diabetes in children in Philadelphia from 2000–2004, compare the epidemiology to the previous three cohorts in the Philadelphia Pediatric Diabetes Registry, and, for the first time, describe the incidence of type 2 diabetes. (A cohort is a group of individuals having a statistical factor (as age or class membership) in common in a demographic study.)

The investigators located cases of diabetes via a retrospective population-based registry. Hospital inpatient and outpatient records were reviewed for cases of type 1 and type 2 diabetes diagnosed from 1 January 2000 to 31 December 2004. The secondary source of validation was the School District of Philadelphia. Time series analysis was used to evaluate the changing pattern of incidence over the 20-year period.

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The researchers found that the overall age-adjusted incidence rate in 2000–2004 of 17.0 per 100,000 per year was significantly higher than that of previous cohorts, with an average yearly increase of 1.5% and an average 5-year cohort increase of 7.8%. The incidence in Caucasian children (19.2 per 100,000 per year) was 48% higher than in the previous cohort. Children aged 0–4 years had a 70% higher incidence (12.2 per 100,000 per year) than the original cohort; this increase was most marked in young African American children. The overall age-adjusted incidence of type 2 diabetes was 5.8 per 100,000 per year and was significantly higher in African American children.

The authors concluded that the incidence of type 1 diabetes is rising among children in Philadelphia. The incidence rate has increased by 29% since the 1985–1989 cohort. The most marked increases were among Caucasian children ages 10–14 years and African American children ages 0–4 years. The incidence of type 1 diabetes is 18 times higher than that of type 2 in Caucasian children but only 1.6 times higher in African American children. The authors could not provide an explanation for the results of their study.

Type 1 diabetes is a chronic disease in which the pancreas produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy. The far more common type 2 diabetes occurs when the body becomes resistant to the effects of insulin or does not make enough insulin. The exact cause of type 1 diabetes is unknown; however, it is likely that a viral or environmental trigger in genetically susceptible people that causes an immune reaction. The body’s white blood cells mistakenly attack the insulin-producing pancreatic beta cells. Despite active research, type 1 diabetes has no cure; however, it can be managed. With proper treatment, people who have the condition can expect to live longer, healthier lives than they did in the past.

Reference: Diabetes Care