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Incidence of Diabetes in Youth in the United States
The Writing Group for the SEARCH for Diabetes in Youth Study Group*
JAMA. 2007;297:2716-2724.
Context Data on the incidence of diabetes mellitus (DM) among US youth according to racial/ethnic background and DM type are limited.
Objective To estimate DM incidence in youth aged younger than 20 years according to race/ethnicity and DM type.
Design, Setting, and Participants A multiethnic, population-based study (The SEARCH for Diabetes in Youth Study) of 2435 youth with newly diagnosed, nonsecondary DM in 2002 and 2003, ascertained at 10 study locations in the United States, covering a population of more than 10 million person-years.
Main Outcome Measure Incidence rates by age group, sex, race/ethnicity, and DM type were calculated per 100 000 person-years at risk. Diabetes mellitus type (type 1/type 2) was based on health care professional assignment and, in a subset, further characterized with glutamic acid decarboxylase (GAD65) autoantibody and fasting C peptide measures.
Results The incidence of DM (per 100 000 person-years) was 24.3 (95% confidence interval [CI], 23.3-25.3). Among children younger than 10 years, most had type 1 DM, regardless of race/ethnicity. The highest rates of type 1 DM were observed in non-Hispanic white youth (18.6, 28.1, and 32.9 for age groups 0-4, 5-9, and 10-14 years, respectively). Even among older youth ( 10 years), type 1 DM was frequent among non-Hispanic white, Hispanic, and African American adolescents. Overall, type 2 DM was still relatively infrequent, but the highest rates (17.0 to 49.4 per 100 000 person-years) were documented among 15- to 19-year-old minority groups.
Conclusions Our data document the incidence rates of type 1 DM among youth of all racial/ethnic groups, with the highest rates in non-Hispanic white youth. Overall, type 2 DM is still relatively infrequent; however, the highest rates were observed among adolescent minority populations.
*SEARCH for Diabetes in Youth Study Writing Group: Dana Dabelea, MD, PhD (University of Colorado Health Sciences Center, Denver); Ronny A. Bell, PhD, MS (Wake Forest University School of Medicine, Winston-Salem, NC); Ralph B. D’Agostino Jr , PhD (Wake Forest University School of Medicine, Winston-Salem, NC); Giuseppina Imperatore, MD, PhD (Centers for Disease Control and Prevention, Atlanta, Ga); Judith M. Johansen, RN, BSN (Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio); Barbara Linder, MD, PhD (National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md); Lenna L. Liu, MD, MPH (University of Washington Child Health Institute, Seattle); Beth Loots, PhD (Children's Hospital and Regional Medical Center, Seattle, Wash); Santica Marcovina, PhD (University of Washington, Seattle); Elizabeth J. Mayer-Davis, MSPH, PhD (University of South Carolina, Columbia); David J. Pettitt, MD (Sansum Diabetes Research Institute, Santa Barbara, Calif); and Beth Waitzfelder, PhD (Pacific Health Research Institute, Honolulu, HI).
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