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Trends in incidence of youth-onset type 1 and type 2 diabetes in the USA, 2002–18: results from the population-based SEARCH for Diabetes in Youth study
Open accessAbstract
Background The incidence of diabetes is increasing in children and young people. We aimed to describe the incidence of type 1 and type 2 diabetes in children and young people aged younger than 20 years over a 17-year period. Methods The SEARCH for Diabetes in Youth study identified children and young people aged 0-19 years with a physician diagnosis of type 1 or type 2 diabetes at five centres in the USA between 2002 and 2018. Eligible participants included non-military and non-institutionalised individuals who resided in one of the study areas at the time of diagnosis. The number of children and young people at risk of diabetes was obtained from the census or health plan member counts. Generalised autoregressive moving average models were used to examine trends, and data are presented as incidence of type 1 diabetes per 100 000 children and young people younger than 20 years and incidence of type 2 diabetes per 100 000 children and young people aged between 10 years and younger than 20 years across categories of age, sex, race or ethnicity, geographical region, and month or season of diagnosis. Findings We identified 18 169 children and young people aged 0-19 years with type 1 diabetes in 85 million person-years and 5293 children and young people aged 10-19 years with type 2 diabetes in 44 million person-years. In 2017-18, the annual incidence of type 1 diabetes was 22·2 per 100 000 and that of type 2 diabetes was 17·9 per 100 000. The model for trend captured both a linear effect and a moving-average effect, with a significant increasing (annual) linear effect for both type 1 diabetes (2·02% [95% CI 1·54-2·49]) and type 2 diabetes (5·31% [4·46-6·17]). Children and young people from racial and ethnic minority groups such as non-Hispanic Black and Hispanic children and young people had greater increases in incidence for both types of diabetes. Peak age at diagnosis was 10 years (95% CI 8-11) for type 1 diabetes and 16 years (16-17) for type 2 diabetes. Season was significant for type 1 diabetes (p=0·0062) and type 2 diabetes (p=0·0006), with a January peak in diagnoses of type 1 diabetes and an August peak in diagnoses of type 2 diabetes. Interpretation The increasing incidence of type 1 and type 2 diabetes in children and young people in the USA will result in an expanding population of young adults at risk of developing early complications of diabetes whose health-care needs will exceed those of their peers. Findings regarding age and season of diagnosis will inform focused prevention efforts. Funding US Centers for Disease Control and Prevention and US National Institutes of Health.
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“In the last decade, the incidence and prevalence of type 2 diabetes in children and adolescents has increased dramatically, especially in certain high-risk racial, ethnic, and ancestral subgroups (115).”
From 2. Diagnosis and classification of diabetes: standards of care in diabetes-2025 (2025) · cites this paper as [115]
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Cites
Prevalence of Obesity Among Adults and Youth: United States, 2015-2016.
Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2017) · PubMed · Cited by 3,889
Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012
Mayer-Davis, E. J., Lawrence, J. M., Dabelea, D., Divers, J., Isom, S., Dolan, L., Imperatore, G., Linder, B., Marcovina, S., Pettitt, D. J., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1610187 · Cited by 1,476
Self-citationPrevalence of Type 1 and Type 2 Diabetes Among Children and Adolescents From 2001 to 2009
Dabelea, D., Mayer-Davis, E. J., Saydah, S., Imperatore, G., Linder, B., Divers, J., Bell, R., Badaru, A., Talton, J. W., Crume, T., et al. (2014) · JAMA · doi:10.1001/jama.2014.3201 · Cited by 1,412
Self-citationDabelea, D., Stafford, J. M., Mayer-Davis, E. J., D’Agostino, R., Dolan, L., Imperatore, G., Linder, B., Lawrence, J. M., Marcovina, S. M., Mottl, A. K., et al. (2017) · JAMA · doi:10.1001/jama.2017.0686 · Cited by 700
Self-citationTrends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017
Lawrence, J. M., Divers, J., Isom, S. P., Saydah, S., Imperatore, G., Pihoker, C., Marcovina, S. M., Mayer‐Davis, E. J., Hamman, R. F., Dolan, L. M., et al. (2021) · JAMA · doi:10.1001/jama.2021.11165 · Cited by 668
Self-citationThe SEARCH for Diabetes in Youth Study: Rationale, Findings, and Future Directions
Hamman, R. F., Bell, R. A., Dabelea, D., D’Agostino, R. B., Dolan, L. M., Imperatore, G., Lawrence, J. M., Linder, B. L., Marcovina, S. M., Mayer‐Davis, E. J., et al. (2014) · Diabetes Care · doi:10.2337/dc14-0574 · Cited by 637
Self-citationPatterson, C., Harjutsalo, V., Rosenbauer, J., Neu, A., Cinek, O., Skrivarhaug, T., Rami-Merhar, B. M., Soltész, G., Svensson, J., Parslow, R. C., et al. (2018) · Diabetologia · doi:10.1007/s00125-018-4763-3 · Cited by 515
Generalized Autoregressive Moving Average Models
Benjamin, M. A., Rigby, R. A., & Stasinopoulos, D. (2003) · Journal of the American Statistical Association · doi:10.1198/016214503388619238 · Cited by 412
Divers, J., Mayer‐Davis, E. J., Lawrence, J. M., Isom, S. P., Dabelea, D., Dolan, L. M., Imperatore, G., Marcovina, S. M., Pettitt, D. J., Pihoker, C., et al. (2020) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6906a3 · Cited by 372
Self-citationAlsaeed, A. H., Constantino, M., Molyneaux, L. M., D'Souza, M. I., Limacher-Gisler, F., Luo, C., Wu, T., Twigg, S. M., Yue, D. K., & Wong, J. (2016) · Diabetes Care · doi:10.2337/dc15-0991 · Cited by 254
Research works printed but not linked: 1
- Tuomilehto, 2020, Epidemiology of childhood type 1 diabetes, Pediatr Endocrinol Rev, 17, 198
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2. Diagnosis and classification of diabetes: standards of care in diabetes-2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Ebekozien, O., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s002 · Cited by 1,393
Martin, S. S., Aday, A. W., Allen, N. B., Almarzooq, Z., Anderson, C. A. M., Arora, P. K., Avery, C. L., Baker-Smith, C. M., Bansal, N., Beaton, A., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001303 · Cited by 1,284
2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s002 · Cited by 473
Palaniappan, L. P., Allen, N. B., Almarzooq, Z., Anderson, C. A. M., Arora, P. K., Avery, C. L., Baker-Smith, C. M., Bansal, N., Currie, M. E., Earlie, R. S., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001412 · Cited by 343
Current insights and emerging trends in early-onset type 2 diabetes
Misra, S., Ke, C., Srinivasan, S., Goyal, A., Nyrienda, M. J., Florez, J. C., Khunti, K., Magliano, D. J., & Luk, A. O. Y. (2023) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(23)00225-5 · Cited by 252
Metadata
- Authors
- Wagenknecht, L. E., Lawrence, J. M., Isom, S., Jensen, E. T., Dabelea, D., Liese, A. D., Dolan, L. M., Shah, A. S., Bellatorre, A., Sauder, K., Marcovina, S., Reynolds, K., Pihoker, C., Imperatore, G., & Divers, J.
- Affiliations
- Wake Forest University Health Sciences (US)
- National Institutes of Health (US)
- University of Colorado Anschutz (US)
- University of South Carolina (US)
- Cincinnati Children's Hospital Medical Center (US)
- Medpace (United States) (US)
- Kaiser Permanente (US)
- University of Washington (US)
- Centers for Disease Control and Prevention (US)
- NYU Grossman Long Island School of Medicine (US)
- ORCID
- Venue
- The Lancet Diabetes & Endocrinology
- Publisher
- Elsevier BV
- Published
- 2023-04
- Volume
- 11
- Issue
- 4
- Pages
- 242-250
- ISSN
- 2213-8587 (ISSN-L)
- PMC
- PMC10091237
- OpenAlex
- W4322603974
- Cited by
- 264
- References
- 30
- Citations by year
- 2026: 73 · 2025: 114 · 2024: 60 · 2023: 17
- FWCI
- 43.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 173 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- The Lancet Diabetes & Endocrinology (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Centers for Disease Control and Prevention (1U18DP006131, U18DP006133, U18DP006134, U18DP006136, U18DP006138, U18DP006139)
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 1 diabetes, type 2 diabetes, youth-onset diabetes, incidence trends, children and young people, SEARCH for Diabetes in Youth, racial and ethnic disparities, age at diagnosis, sex differences, non-Hispanic Black youth, Latino youth, diabetes risk factors, physical inactivity, family history of diabetes, environmental risk factors
- MeSH terms
- Adolescent, Child, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Ethnicity, Humans, Infant, Minority Groups, United States, Incidence, Young Adult
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