Into the Mouths of Babes: The Diabetes Epidemic in Children

doi:10.2337/diaclin.19.3.102

Into the Mouths of Babes: The Diabetes Epidemic in Children

Claresa Levetan, MD

STUDY

Fagot-Campagna A, Pettit DJ, Engelgau MM, Burrows NR, Geiss LS, Baldez R, Beckles GI, Saaddine J, Gregg EW, Williamson DF, Narayan KMV: Type 2 diabetes among North American children and adolescents: an epidemiological review and a public health perspective. J Pediatr 136:664–672, 2000

SUMMARY

Objective. To review the magnitude, characteristics, and public health importance of type 2 diabetes in North American youth.

Methods. One hundred eighty-two publications on type 2 diabetes in youth published between January 1996 and June 1999 were reviewed by the Division of Diabetes Translation at the Centers for Disease Control and Prevention, the Sansum Medical Research Institute, and the Indian Health Service.

Results. Records of 578 youth diagnosed with type 2 diabetes were reviewed from the available studies. Ninety-four percent of the children and adolescents were from minority communities, and minorities with type 2 diabetes were overrepresented relative to their population size. The mean age of diagnosis ranged from 12 to 14 years except among Pima Indians, for whom the mean age was 16 years. Patients were more likely to be girls than boys. Obesity, family history of diabetes, and acanthosis nigricans were common among this population.

Conclusions. Type 2 diabetes has been an important problem among African Americans, Native Americans, and some ethnic minorities and is now emerging in all populations. Type 2 diabetes among youth is an emerging public health problem.

COMMENTARY

The Tip of the Diabetes Iceberg

This study points out the epidemiology and characteristics of type 2 diabetes among children and adolescents in this country. It also suggests the need for further epidemiological study, particularly of the nonminority population for which data on the prevalence of type 2 diabetes among children and adolescents are more scarce.

Unfortunately, this study likely underreports the diagnosis of type 2 diabetes among private practice settings because the studies it reviewed were typically from minority health services and large medical centers rather than from communities of patients receiving their care from pediatricians and pediatric endocrinologists in private practice.