Diabetes incidence projected to increase among youth in U.S.

A modeling study using data from 2002-2017 found that incidence of type 1 and type 2 diabetes could increase in those under age 20 years by up to 65% and 673%, respectively, over the next three decades, although confidence intervals were wide.

Diabetes prevalence in the U.S. could increase substantially by 2060 among young people, according to a recent study.

Researchers used a mathematical model and data from the SEARCH for Diabetes in Youth study from 2002-2017 to project the prevalence and number of youths with type 1 and type 2 diabetes through 2060, as well as trends in racial and ethnic disparities. The SEARCH study is a population-based multicenter study of youth younger than 20 years of age from six U.S. regions. The researchers made their projections under both a constant incidence scenario, which predicted prevalence would remain stable until 2060, and an increasing incidence scenario, which predicted prevalence would increase in all racial and ethnic groups. The results were published Dec. 29, 2022, by Diabetes Care.

In the constant incidence scenario, the projected number of youths with diabetes in the U.S. increased from 213,000 (95% CI, 209,000 to 218,000) in 2017 to 239,000 (95% CI, 209,000 to 282,000) in 2060. Of the 213,000 youths with diabetes in 2017, 185,000 had type 1 diabetes and 28,000 had type 2; of the 239,000 projected to have diabetes in 2060, 191,000 were projected to have type 1 and 48,000 type 2. Corresponding relative increases for type 1 and type 2 diabetes from 2017 to 2060 were 3% (95% CI, −9% to 21%) and 69% (95% CI, 43% to 109%), respectively. In the increasing incidence scenario, the number of youths projected to have diabetes in 2060 was 526,000 (95% CI, 335,000 to 893,000), with 306,000 cases of type 1 and 220,000 of type 2, and corresponding relative increases of 65% (95% CI, 12% to 158%) and 673% (95% CI, 362% to 1,341%), respectively. The researchers found substantial widening of racial and ethnic disparities in type 2 diabetes prevalence in both the constant and increasing incidence scenarios, especially among non-Hispanic Black youths.

The SEARCH study provided data only on diagnosed diabetes, the CIs for several of the estimates were wide, and the results may not be generalizable to all U.S. geographic regions, the authors noted. They concluded that the number of youths with diabetes in the U.S. is projected to increase substantially over the next few decades and that this emphasizes the importance of additional research on and implementation of interventions for primary and secondary prevention. “The projected trends indicate a substantial widening of the gap in health disparities in type 2 diabetes prevalence, with the highest estimates for [non-Hispanic Black] youth,” the authors wrote. “If the current trends continue, U.S. health care systems could face an increasing demand of youth-onset diabetes health care services, resulting in increasing health care costs.”