Surprising Findings Emerge from a National Study on Diabetes among Youth

A study called SEARCH for Diabetes in Youth has found that, despite national media attention on the skyrocketing rates of type 2 diabetes in children, the majority of new cases of diabetes in children are type 1.  SEARCH also found that in ages from 10 to 19, type 1 diabetes has been diagnosed in children of all races. 

Also surprising to researchers was that the children diagnosed with type 1 diabetes had higher rates of obesity than children without diabetes: 30 percent were classified as overweight, and 44 percent were at risk of becoming overweight.  These findings have raised the question of whether obesity fuels type 1 disease, which is not part of traditional thought of what causes type 1.  Additionally, it was found that only 10.5 percent of children and adolescents with type 1 met the American Heart Association recommendation of less than 30 percent daily total fat consumption.  And only 10 percent met the U.S. Department of Agriculture guidelines for the number of daily servings of fruit and vegetables. 

The most troubling and unexpected finding out of this study, however, is the number of children and adolescents with “hybrid” diabetes, or what some researchers refer to as “double” or “type 1 1/2,” a condition that includes symptoms of both type 1 and type 2 diabetes.  The study showed that in children with a clinical diagnosis of type 2 diabetes, about 30 percent actually had evidence of diabetes autoantibodies, which are typically associated with type 1 diabetes.

According to the Centers for Disease Control and Prevention (CDC), approximately 150,000, or about one in every 400 to 500 children have diabetes.  Each year, more than 13,000 young people are diagnosed with type 1 diabetes.  People with diabetes are at great risk of developing serious health complications over time, including heart disease, kidney disease, blindness, and stroke. 

Type 1 diabetes develops when the body’s immune systems destroys pancreatic cells that make the hormone insulin that regulates blood sugar.  It normally strikes children and young adults, and people with type 1 diabetes must have daily insulin injections to survive.  Type 2 diabetes begins when the body develops a resistance to insulin and no longer uses the insulin properly.  As the need for insulin rises, the pancreas gradually loses its ability to produce sufficient amounts of insulin to regulate blood sugar. 

Among SEARCH study participants (from the major ethnic and racial groups of the U.S.) up to the age of 14, the highest prevalence of diabetes was found among non-Hispanic whites.  But in youth aged 15 to 19, the highest prevalence rate was found in African Americans, while the highest incidence rate was in American Indians. 

Study Findings Show the Need to Promote Healthy Eating and Physical Activity in Schools

The findings from the SEARCH study show that family history plays a major role in determining who develops diabetes.  Being overweight or obese and/or having poor eating habits can also be strong predictors of those who might develop either type 1 or type 2 diabetes. 

Schools present a unique opportunity to help ward off the increase of diabetes among youth.  Children spend countless hours in school during a year.  Through Coordinated School Health Programs, schools can implement effective programs and policies in which children engage in and learn about eating healthy and being physically active to prevent the spread of overweight and obesity as well as many of the diseases associated with those conditions such as diabetes.  Schools can, for instance, require that kids have 60 minutes of physical activity daily and can offer nutritious meals in the school cafeteria.  They can also be catalysts for family and community involvement so that efforts are not confined to the school environment, but rather reinforced at home and other places within the community.

The Future of SEARCH

SEARCH is the first study to include all races and ethnic groups. The first phase of SEARCH ended in October 2005, and a phase II study is underway.  Co-sponsored by the CDC and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), SEARCH II will follow the health care the study participants receive and their health outcomes, which will help determine what their long-term risk factors may be as adults. Moreover, study participants with hybrid diabetes will be monitored closely to watch for disease progression and health complications.

For additional information on SEARCH and its findings, please visit http://www.searchfordiabetes.org/.

Source:  “Who Has Diabetes,” Jo Cavallo, JDRF Countdown, Spring 2006, and “SEARCH for Diabetes in Youth”, Fact Sheet, CDC.