title: Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012.
abstract: Diagnoses of type 1 and type 2 diabetes in youths present a substantial clinical and public health burden. The prevalence of these diseases increased in the 2001-2009 period, but data on recent incidence trends are lacking.
  
  
  
  We ascertained cases of type 1 and type 2 diabetes mellitus at five study centers in the United States. Denominators (4.9 million youths annually) were obtained from the U.S. Census or health-plan member counts. After the calculation of annual incidence rates for the 2002-2012 period, we analyzed trends using generalized autoregressive moving-average models with 2-year moving averages.
  
  
  
  A total of 11,245 youths with type 1 diabetes (0 to 19 years of age) and 2846 with type 2 diabetes (10 to 19 years of age) were identified. Overall unadjusted estimated incidence rates of type 1 diabetes increased by 1.4% annually (from 19.5 cases per 100,000 youths per year in 2002-2003 to 21.7 cases per 100,000 youths per year in 2011-2012, P=0.03). In adjusted pairwise comparisons, the annual rate of increase was greater among Hispanics than among non-Hispanic whites (4.2% vs. 1.2%, P<0.001). Overall unadjusted incidence rates of type 2 diabetes increased by 7.1% annually (from 9.0 cases per 100,000 youths per year in 2002-2003 to 12.5 cases per 100,000 youths per year in 2011-2012, P<0.001 for trend across race or ethnic group, sex, and age subgroups). Adjusted pairwise comparisons showed that the relative annual increase in the incidence of type 2 diabetes among non-Hispanic whites (0.6%) was lower than that among non-Hispanic blacks, Asians or Pacific Islanders, and Native Americans (P<0.05 for all comparisons) and that the annual rate of increase among Hispanics differed significantly from that among Native Americans (3.1% vs. 8.9%, P=0.01). After adjustment for age, sex, and race or ethnic group, the relative annual increase in the incidence of type 1 diabetes was 1.8% (P<0.001) and that of type 2 diabetes was 4.8% (P<0.001).
  
  
  
  The incidences of both type 1 and type 2 diabetes among youths increased significantly in the 2002-2012 period, particularly among youths of minority racial and ethnic groups. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the Centers for Disease Control and Prevention.).
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Mayer-Davis
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Jean M
authors.initials: JM
authors.lastname: Lawrence
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Divers
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Scott
authors.initials: S
authors.lastname: Isom
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Dolan
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Imperatore
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Barbara
authors.initials: B
authors.lastname: Linder
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Santica
authors.initials: S
authors.lastname: Marcovina
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: David J
authors.initials: DJ
authors.lastname: Pettitt
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Catherine
authors.initials: C
authors.lastname: Pihoker
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Sharon
authors.initials: S
authors.lastname: Saydah
authors.affiliation: From the Departments of Nutrition and Medicine, University of North Carolina, Chapel Hill (E.J.M.-D.), and the Department of Biostatistical Sciences (J.D., S.I.) and the Division of Public Health Sciences (L.W.), Wake Forest School of Medicine, Winston-Salem - both in North Carolina; the Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena (J.M.L.), and Santa Barbara (D.J.P.) - both in California; the Department of Epidemiology, Colorado School of Public Health, Aurora (D.D.); the Department of Endocrinology, Children's Hospital Medical Center, Cincinnati (L.D.); the Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta (G.I., S.S.); the Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (B.L.); and the Northwest Lipid Research Laboratory (S.M.) and the Department of Pediatrics, University of Washington (C.P.) - both in Seattle.
authors.forename: Lynne
authors.initials: L
authors.lastname: Wagenknecht
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D014481:United States / Q000453:epidemiology; D055815:Young Adult