Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017
Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017
复制标题
DOI：
10.1001/jama.2021.11165
复制
发表时间：
2021-08-24
影响因子：
120.7
通讯作者：
Liese, Angela D.
中科院分区：
文献类型：
--
作者：
Lawrence, Jean M.;Divers, Jasmin;Liese, Angela D.
2001年至2017年，美国20岁以下人群中1型和2型糖尿病的患病率是否发生了变化？在这项观察性、横断面、多中心研究中，来自美国6个地区的平均347万青年人，19岁或以下的1型糖尿病患病率显著增加，从每1000名青年1.48人增加到每1000名青年2.15人，而10至19岁年龄段的2型糖尿病患病率估计从每千名青年0.34人增加到每千名青年0.67人。2001年至2017年，在美国的6个地区，儿童和青少年1型和2型糖尿病的估计患病率显著增加。目的评估2001年至2017年美国青少年1型和2型糖尿病患病率的变化。在这项横断面观察性研究中，2001年，2009年和2017年，美国6个地区（4个地理区域，1个健康计划和选择的美国印第安人保留地）的20岁以下的医生诊断的糖尿病患者被枚举。Exposures日历年。主要结果和测量：医生诊断的1型和2型糖尿病的总体患病率估计值，以及种族、年龄和性别。结果在19岁及以下的青少年中，2001年335万人中有4958人患有1型糖尿病，2009年346万人中有6672人患有1型糖尿病，2017年361万人中有7759人患有1型糖尿病;在10至19岁的人群中，2001年173万人中有588人患有2型糖尿病，2009年185万人中有814人患有2型糖尿病，2017年185万人中有1230人患有2型糖尿病。每1000名19岁或以下青年的1型糖尿病患病率估计值从1.48（95%可信区间，1.44-1.52），2001年降至1.93（95% CI，1.88-1.98）从2009年的2.15（95%CI，2.10-2.20），16年来每1000名青年绝对增加0.67人（95%，CI，0.64-0.70），相对增加45.1%（95%CI，40.0%-50.4%）。在非西班牙裔白色（0.93/1000青年[95%CI，0.88-0.98]）和非西班牙裔黑人（0.89/1000青年[95%CI，0.88-0.98]）青年中观察到最大的绝对增加。每1000名10至19岁青年的2型糖尿病患病率估计值从0.34（95%置信区间，0.31-0.37），2001年为0.46（95% CI，0.43-0.49）从2009年的0.67（95%CI，0.63-0.70），16年间每1000名青年中绝对增加0.32人（95%CI，0.30-0.35），相对增加95.3%（95%CI，77.0%-115.4%）。在非西班牙裔黑人（0.85/1000青年[95%CI，0.74-0.97]）和西班牙裔（0.57/1000青年[95%CI，0.51-0.64]）青年中观察到最大的绝对增加。结论和相关性2001年至2017年，美国6个地区儿童和青少年1型和2型糖尿病的估计患病率均有所增加。这项横断面研究使用了2001年、2009年和2017年美国6个地区的数据，以检查观察到的不同类型糖尿病的青年发病糖尿病患病率趋势是否存在差异，种族和民族，年龄和性别。
Key PointsQuestionHas the prevalence of type 1 and type 2 diabetes changed from 2001 to 2017 among those younger than 20 years in the US? FindingsIn this observational, cross-sectional, multicenter study of a mean of 3.47 million youths for each prevalence year from 6 areas in the US, the estimated prevalence of type 1 diabetes among those 19 years or younger increased significantly, from 1.48 per 1000 youths to 2.15 per 1000 youths, and the estimated prevalence of type 2 diabetes among those aged 10 to 19 years increased from 0.34 per 1000 youths to 0.67 per 1000 youths. MeaningIn 6 areas of the US from 2001 to 2017, the estimated prevalence of diabetes among children and adolescents increased significantly for both type 1 and type 2 diabetes.ImportanceChanges in the prevalence of youth-onset diabetes have previously been observed. ObjectiveTo estimate changes in prevalence of type 1 and type 2 diabetes in youths in the US from 2001 to 2017. Design, Setting, and ParticipantsIn 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. ExposuresCalendar year. Main Outcomes and MeasuresEstimated prevalence of physician-diagnosed type 1 and type 2 diabetes overall and by race and ethnicity, age, and sex. ResultsAmong 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 RelevanceIn 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.This cross-sectional study uses data from 6 areas in the US from 2001, 2009, and 2017 to examine whether differences exist in observed trends in youth-onset diabetes prevalence by diabetes type, race and ethnicity, age, and sex.