Division of Epidemiologic Research, Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena.
Division of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
JAMA. 2021 Aug 24;326(8):717-727. doi: 10.1001/jama.2021.11165.
IMPORTANCE: Changes in the prevalence of youth-onset diabetes have previously been observed. OBJECTIVE: To estimate changes in prevalence of type 1 and type 2 diabetes in youths in the US from 2001 to 2017. DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional observational study, individuals younger than 20 years with physician-diagnosed diabetes were enumerated from 6 areas in the US (4 geographic areas, 1 health plan, and select American Indian reservations) for 2001, 2009, and 2017. EXPOSURES: Calendar year. MAIN OUTCOMES AND MEASURES: Estimated prevalence of physician-diagnosed type 1 and type 2 diabetes overall and by race and ethnicity, age, and sex. RESULTS: Among youths 19 years or younger, 4958 of 3.35 million had type 1 diabetes in 2001, 6672 of 3.46 million had type 1 diabetes in 2009, and 7759 of 3.61 million had type 1 diabetes in 2017; among those aged 10 to 19 years, 588 of 1.73 million had type 2 diabetes in 2001, 814 of 1.85 million had type 2 diabetes in 2009, and 1230 of 1.85 million had type 2 diabetes in 2017. The estimated type 1 diabetes prevalence per 1000 youths for those 19 years or younger increased significantly from 1.48 (95% CI, 1.44-1.52) in 2001 to 1.93 (95% CI, 1.88-1.98) in 2009 to 2.15 (95% CI, 2.10-2.20) in 2017, an absolute increase of 0.67 per 1000 youths (95%, CI, 0.64-0.70) and a 45.1% (95% CI, 40.0%-50.4%) relative increase over 16 years. The greatest absolute increases were observed among non-Hispanic White (0.93 per 1000 youths [95% CI, 0.88-0.98]) and non-Hispanic Black (0.89 per 1000 youths [95% CI, 0.88-0.98]) youths. The estimated type 2 diabetes prevalence per 1000 youths aged 10 to 19 years increased significantly from 0.34 (95% CI, 0.31-0.37) in 2001 to 0.46 (95% CI, 0.43-0.49) in 2009 to 0.67 (95% CI, 0.63-0.70) in 2017, an absolute increase of 0.32 per 1000 youths (95% CI, 0.30-0.35) and a 95.3% (95% CI, 77.0%-115.4%) relative increase over 16 years. The greatest absolute increases were observed among non-Hispanic Black (0.85 per 1000 youths [95% CI, 0.74-0.97]) and Hispanic (0.57 per 1000 youths [95% CI, 0.51-0.64]) youths. CONCLUSIONS AND RELEVANCE: In 6 areas of the US from 2001 to 2017, the estimated prevalence of diabetes among children and adolescents increased for both type 1 and type 2 diabetes.
重要性：之前已经观察到青少年发病的糖尿病患病率发生了变化。 目的：估计美国青少年 1 型和 2 型糖尿病的患病率从 2001 年到 2017 年的变化情况。 设计、地点和参与者：在这项横断面观察性研究中，从美国 6 个地区（4 个地理区域、1 个健康计划和一些选择的美洲印第安人保留地）中，列举了年龄小于 20 岁、经医生诊断患有糖尿病的个体，时间范围为 2001 年、2009 年和 2017 年。 暴露因素：日历年份。 主要结局和测量指标：总体及按种族和族裔、年龄和性别划分的 1 型和 2 型糖尿病的估计患病率。 结果：在 19 岁或以下的青少年中，2001 年有 4958 例（3350 万人）患有 1 型糖尿病，2009 年有 6672 例（3460 万人）患有 1 型糖尿病，2017 年有 7759 例（3610 万人）患有 1 型糖尿病；在 10 至 19 岁的人群中，2001 年有 588 例（1730 万人）患有 2 型糖尿病，2009 年有 814 例（1850 万人）患有 2 型糖尿病，2017 年有 1230 例（1850 万人）患有 2 型糖尿病。对于 19 岁或以下的青少年，每 1000 名青少年中 1 型糖尿病的估计患病率从 2001 年的 1.48（95%CI，1.44-1.52）显著增加到 2009 年的 1.93（95%CI，1.88-1.98），到 2017 年的 2.15（95%CI，2.10-2.20），绝对值增加了 0.67（95%CI，0.64-0.70），16 年来相对增加了 45.1%（95%CI，40.0%-50.4%）。在非西班牙裔白人和非西班牙裔黑人群体中观察到的绝对增加最大，分别为每 1000 名青少年增加 0.93（95%CI，0.88-0.98）和 0.89（95%CI，0.88-0.98）。10 至 19 岁青少年中每 1000 名青少年中 2 型糖尿病的估计患病率从 2001 年的 0.34（95%CI，0.31-0.37）显著增加到 2009 年的 0.46（95%CI，0.43-0.49），到 2017 年的 0.67（95%CI，0.63-0.70），绝对值增加了 0.32（95%CI，0.30-0.35），16 年来相对增加了 95.3%（95%CI，77.0%-115.4%）。在非西班牙裔黑人和西班牙裔青少年中观察到的绝对增加最大，分别为每 1000 名青少年增加 0.85（95%CI，0.74-0.97）和 0.57（95%CI，0.51-0.64）。 结论和相关性：在美国 6 个地区，从 2001 年到 2017 年，儿童和青少年的 1 型和 2 型糖尿病的估计患病率都有所增加。
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