‘Grandparents’ diabetes’ is becoming increasingly common amongst young people: cases have increased tenfold in twenty years
A study reveals an increasingly early onset and rising incidence of type 2 diabetes, which has surged amongst teenagers, mainly due to childhood obesity
Key points
Until recently, type 2 diabetes was considered a disease of middle age or old age, typically developing after the age of fifty, often linked to being a few kilos overweight and a sedentary lifestyle. However, a study by the Colorado School of Public Health – which is among the presentations at the forthcoming European Association for the Study of Diabetes (EASD) congress, due to take place in Milan at the end of September – reveals an increasingly early and widespread onset of this condition amongst very young people, with a rate of progression that the researchers themselves describe as unprecedented.
Data from the study
The team of American researchers, led by Dr Tessa Crume, analysed more than two decades of data collected by the Colorado Diabetes Registry, a surveillance system that, since 2002, has been monitoring every new diagnosis of diabetes among people under the age of 20 across the state, by cross-referencing diagnostic codes, laboratory tests and medication prescriptions. Between 2002 and 2023, 8,094 new cases of type 1 diabetes were recorded among very young children and 1,560 new cases of type 2 diabetes among young people aged 10–19. Whilst the incidence of type 1 has remained broadly stable (rising from 25.07 to 27.39 cases per 100,000 young people), that of type 2 diabetes has literally skyrocketed, rising from 2.37 to 22.30 cases per 100,000 adolescents. This represents an almost tenfold increase, with a particularly marked acceleration from 2014 onwards.
A growing trend in the United States
“Just a generation ago, type 2 diabetes in teenagers was so rare that many paediatricians ended their careers without ever having seen a single case, as it was typically a disease of middle age,” comments Dr Crume. “ “In Colorado, however, we have seen a tenfold increase in cases amongst very young people in just two decades, and this rise is accelerating rather than slowing down,” But the phenomenon is by no means confined to Colorado alone. The larger SEARCH for Diabetes in Youth study also confirms that, among American adolescents, type 2 diabetes is now set to overtake the classic form of paediatric diabetes, type 1, in terms of the number of new cases.
The role of childhood obesity
Behind this surge in ‘type 2’ diabetes amongst young people lies the general rise in childhood obesity. A teenager with a high body mass index who arrives at hospital with sky-high blood sugar levels may today have either type 1 or type 2 diabetes: only by testing for specific autoantibodies (Type 1 diabetes is an autoimmune disease) and assessing insulin resistance can the two conditions be distinguished. And this is a crucial diagnostic distinction, upon which the entire treatment strategy depends. “We therefore need services,” the researcher warns, “that not only enable us to treat a growing number of young people, but also ensure that every child with newly diagnosed diabetes receives appropriate metabolic and autoantibody tests, rather than simply being classified as ‘type 1’ based solely on age and established practice.”
The real cause for concern, however, lies in what happens after diagnosis. Type 2 diabetes in a fourteen-year-old is not the same condition as that which develops in a middle-aged adult: in young people, the insulin-producing cells in the pancreas are depleted more rapidly, blood sugar levels are more difficult to control, and complications affecting the kidneys, eyes, nerves and heart can develop within a few years, rather than over decades as is the case with the classic ‘type 2’ seen in older or middle-aged people.
