Types of diabetes are not limited to age groups: type 1 diabetes in adults and type 2 diabetes in children and adolescents

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Abstract

Based on data from the national diabetes registry DPV (Diabetes patient documentation), the diabetes registry of North Rhine-Westphalia and surveys conducted at hospitals and practices in Baden-Württemberg and Saxony, this study estimates the incidence and prevalence of type 1 diabetes in over-18-year-old adults and type 2 diabetes in 11- to 18-year-old children and adolescents.

The national incidence of type 1 diabetes in adults was 6.1 per 100,000 person-years from 2014 to 2016, with slightly lower figures for women compared to men. Annually, around 4,150 adults develop type 1 diabetes. In 2016, the prevalence of type 1 diabetes was estimated at 493 per 100,000 persons and was lower in women at 445 per 100,000 people than in men at 544 per 100,000. Based on this data, there were around 341,000 adults with type 1 diabetes in 2016.

For 11- to 18-year-old children and adolescents, the national incidence of type 2 diabetes was 2.8 per 100,000 person-years between 2014 and 2016 and higher for girls than for boys. Annually, around 175 adolescents in this age group develop type 2 diabetes. The incidence estimates for Saxony were higher (4.3 per 100,000 person-years). The prevalence of type 2 diabetes between 2014 and 2016 for 11- to 18-year-old children and adolescents was estimated between 12 and 18 cases per 100,000 persons. During this period, there were about 950 children and adolescents of this age group with type 2 diabetes in Germany.

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Trends in childhood type 1 diabetes incidence in Europe during 1989-2008: evidence of non-uniformity over time in rates of increase.

C Patterson, E Gyürüs, J. Rosenbauer … (2012)

The aim of the study was to describe 20-year incidence trends for childhood type 1 diabetes in 23 EURODIAB centres and compare rates of increase in the first (1989-1998) and second (1999-2008) halves of the period. All registers operate in geographically defined regions and are based on a clinical diagnosis. Completeness of registration is assessed by capture-recapture methodology. Twenty-three centres in 19 countries registered 49,969 new cases of type 1 diabetes in individuals diagnosed before their 15th birthday during the period studied. Ascertainment exceeded 90% in most registers. During the 20-year period, all but one register showed statistically significant changes in incidence, with rates universally increasing. When estimated separately for the first and second halves of the period, the median rates of increase were similar: 3.4% per annum and 3.3% per annum, respectively. However, rates of increase differed significantly between the first half and the second half for nine of the 21 registers with adequate coverage of both periods; five registers showed significantly higher rates of increase in the first half, and four significantly higher rates in the second half. The incidence rate of childhood type 1 diabetes continues to rise across Europe by an average of approximately 3-4% per annum, but the increase is not necessarily uniform, showing periods of less rapid and more rapid increase in incidence in some registers. This pattern of change suggests that important risk exposures differ over time in different European countries. Further time trend analysis and comparison of the patterns in defined regions is warranted.

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Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective.

A Fagot-Campagna, D J Pettitt, M M Engelgau … (2000)

To review the magnitude, characteristics, and public health importance of type 2 diabetes in North American youth. Among 15- to 19-year-old North American Indians, prevalence of type 2 diabetes per 1000 was 50.9 for Pima Indians, 4.5 for all US American Indians, and 2.3 for Canadian Cree and Ojibway Indians in Manitoba. From 1967-1976 to 1987-1996, prevalence increased 6-fold for Pima Indian adolescents. Among African Americans and whites aged 10 to 19 years in Ohio, type 2 diabetes accounted for 33% of all cases of diabetes. Youth with type 2 diabetes were generally 10 to 19 years old, were obese and had a family history of type 2 diabetes, had acanthosis nigricans, belonged to minority populations, and were more likely to be girls than boys. At follow-up, glucose control was often poor, and diabetic complications could occur early. Type 2 diabetes is an important problem among American Indian and First Nation youth. Other populations have not been well studied, but cases are now occurring in all population groups, especially in ethnic minorities. Type 2 diabetes among youth is an emerging public health problem, for which there is a great potential to improve primary and secondary prevention.

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Type 2 diabetes mellitus in children and adolescents.

Thomas Reinehr (2013)

Type 2 diabetes mellitus is emerging as a new clinical problem within pediatric practice. Recent reports indicate an increasing prevalence of type 2 diabetes mellitus in children and adolescents around the world in all ethnicities, even if the prevalence of obesity is not increasing any more. The majority of young people diagnosed with type 2 diabetes mellitus was found in specific ethnic subgroups such as African-American, Hispanic, Asian/Pacific Islanders and American Indians. Clinicians should be aware of the frequent mild or asymptomatic manifestation of type 2 diabetes mellitus in childhood. Therefore, a screening seems meaningful especially in high risk groups such as children and adolescents with obesity, relatives with type 2 diabetes mellitus, and clinical features of insulin resistance (hypertension, dyslipidemia, polycystic ovarian syndrome, or acanthosis nigricans). Treatment of choice is lifestyle intervention followed by pharmacological treatment (e.g., metformin). New drugs such as dipeptidyl peptidase inhibitors or glucagon like peptide 1 mimetics are in the pipeline for treatment of youth with type 2 diabetes mellitus. However, recent reports indicate a high dropout of the medical care system of adolescents with type 2 diabetes mellitus suggesting that management of children and adolescents with type 2 diabetes mellitus requires some remodeling of current healthcare practices.

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Author and article information

Journal

Journal ID (nlm-ta): J Health Monit

Journal ID (iso-abbrev): J Health Monit

Journal ID (publisher-id): JoHM

Title: Journal of Health Monitoring

Publisher: Robert Koch Institute (Nordufer 20 13353 Berlin, Germany )

ISSN (Electronic): 2511-2708

Publication date (Electronic): 27 June 2019

Publication date Collection: June 2019

Volume: 4

Issue: 2

Pages: 29-49

Affiliations

[1 ] German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-Universität Düsseldorf, Institute for Biometrics and Epidemiology

[2 ] German Center for Diabetes Research (DZD) , München-Neuherberg

[3 ] University Children’s Hospital Tübingen

[4 ] Technische Universität Dresden , Faculty of Medicine Carl Gustav Carus, Health Sciences/Public Health

[5 ] Division of Endocrinology and Diabetology, Department of Medicine II, Medical Center – University of Freiburg , Faculty of Medicine, University of Freiburg

[6 ] Ulm University, Institute of Epidemiology and Medical Biometry , ZIBMT

Author notes

Corresponding author Prof Dr Reinhard W. Holl, Ulm University, Institute of Epidemiology and Medical Biometry, ZIBMT, Albert-Einstein-Allee 41, 89081 Ulm, E-mail: reinhard.holl@ 123456uni-ulm.de

Article

DOI: 10.25646/5987

PMC ID: 8822252

PubMed ID: 35146246

SO-VID: 428b9704-2a17-4af1-9ba4-b404b428ca94

License:

This work is licensed under a Creative Commons Attribution 4.0 International License.

History

Date received : 11 December 2018

Date accepted : 09 April 2019

Page count

Figures: 2, Tables: 3, Equations: 0, References: 46, Pages: 21

Funding

Funded by: Federal Ministry of Health

Award ID: GE 2016 03 24

Award Recipient : Diabetes Surveillance

Funded by: German Center for Diabetes Research

Award ID: 82DZD01402

Award ID: 82DZD00202

Award Recipient : Diabetes Surveillance

Funded by: German Diabetes Association

Award Recipient : Diabetes Surveillance

Parts of the results presented here were funded in the form of a co-operation project by the Federal Ministry of Health within the framework to establish a National Diabetes Surveillance at the Robert Koch Institute (funding code: GE 2016 03 24). Further funding was received from the German Center for Diabetes Research (funding codes: 82DZD01402, 82DZD00202) and the German Diabetes Association.

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Types of diabetes are not limited to age groups: type 1 diabetes in adults and type 2 diabetes in children and adolescents

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Most cited references 43

Trends in childhood type 1 diabetes incidence in Europe during 1989-2008: evidence of non-uniformity over time in rates of increase.

Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective.

Type 2 diabetes mellitus in children and adolescents.

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