Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective.
OBJECTIVE
To review the magnitude, characteristics, and public health importance of type 2 diabetes in North American youth.


RESULTS
Among 15- to 19-year-old North American Indians, prevalence of type 2 diabetes per 1000 was 50.9 for Pima Indians, 4.5 for all US American Indians, and 2.3 for Canadian Cree and Ojibway Indians in Manitoba. From 1967-1976 to 1987-1996, prevalence increased 6-fold for Pima Indian adolescents. Among African Americans and whites aged 10 to 19 years in Ohio, type 2 diabetes accounted for 33% of all cases of diabetes. Youth with type 2 diabetes were generally 10 to 19 years old, were obese and had a family history of type 2 diabetes, had acanthosis nigricans, belonged to minority populations, and were more likely to be girls than boys. At follow-up, glucose control was often poor, and diabetic complications could occur early.


CONCLUSIONS
Type 2 diabetes is an important problem among American Indian and First Nation youth. Other populations have not been well studied, but cases are now occurring in all population groups, especially in ethnic minorities. Type 2 diabetes among youth is an emerging public health problem, for which there is a great potential to improve primary and secondary prevention.
Fagot-Campagna
A
A
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Pettitt
D J
DJ
Engelgau
M M
MM
Burrows
N R
NR
Geiss
L S
LS
Valdez
R
R
Beckles
G L
GL
Saaddine
J
J
Gregg
E W
EW
Williamson
D F
DF
Narayan
K M
KM
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D011634:Public Health; D012042:Registries / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data