Continuing rise of Type 2 diabetes incidence in children and young people in the UK

Abstract

AimsTo estimate the incidence of Type 2 diabetes in children aged <17 years, compare this with similar data 10 years ago, and characterize clinical features at diagnosis in the UK and Republic of Ireland.MethodsUsing the British Paediatric Surveillance Unit reporting framework, cases of Type 2 diabetes diagnosed in children aged <17 years between 1 April 2015 and 30 April 2016 were reported each month.ResultsA total of 106 cases were reported, giving a UK incidence of 0.72/100 000 (95% CI 0.58–0.88). Children from ethnic minorities had significantly higher incidence compared with white children (0.44/100 000) with rates of 2.92/100 000 and 1.67/100 000, in Asian and BACBB (black/African/Caribbean/black British) children respectively. Sixty‐seven percent were girls and 81% had a family history of Type 2 diabetes. The mean BMI sd score at diagnosis was 2.89 (2.88, girls; 2.92, boys); 81% were obese. Children of Asian ethnicity had a significantly lower BMI sd score compared with white children (P<0.001). There was a trend in increased incidence from 2005 to 2015, with a rate ratio of 1.35 (95% CI 0.99–1.84), although this was not statistically significant (P=0.062). There was statistical evidence of increased incidence among girls (P=0.03) and children of South‐Asian ethnicity (P=0.01) when comparing the 2005 and 2015 surveys.ConclusionsType 2 diabetes remains far less common than Type 1 diabetes in childhood in the UK, but the number of cases continues to rise, with significantly increased incidence among girls and South‐Asian children over a decade. Female gender, family history, non‐white ethnicity and obesity were found to be strongly associated with the condition.

Treatment adherence and BMI reduction are key predictors of HbA1c 1 year after diagnosis of childhood type 2 diabetes in the United Kingdom

“…At follow‐up 74.2% were obese and 19.8% overweight. There was evidence that Asian cases had lower BMI SDS at follow‐up (−0.49 lower BMI SDS compared to white children, P = 0.009) which is similar to that reported at baseline …”

“…Globally, the highest incidence of T2DM in youth is in the United States, with 12.5 cases per 100 000 per year . Recently, we reported the 2015‐2016 UK incidence of T2DM in youth as 0.72 per 100 000 per year, with significant increases across a decade among South‐Asians and females . Our study, demonstrated that non‐white ethnicity, female gender, family history, and obesity were strongly associated with disease similar to reports from other countries …”

“…A prospective monthly surveillance of over 3400 consultant pediatricians in the United Kingdom and the Republic of Ireland (ROI) using the British Paediatric Surveillance Unit (BPSU) based at the Royal College of Paediatrics and Child Health (RCPCH), UK, was undertaken to identify new cases of T2DM in children under the age of 17 years between April 2015 and April 2016, with planned follow‐up at 1‐year following diagnosis. The initial study calculated the incidence and characterized the presentation of cases of T2DM . In summary, during this period, an orange report card containing a list of conditions (including T2DM) was sent monthly, by post or electronically, to all consultant pediatricians in the United Kingdom and ROI.…”

Vulnerabilities in diabetic eye screening for children and young people in England

“…Prevalence of type 2 diabetes in children is also increasing, for example in the US, it was recently reported that more than 2 per 1000 children <18 years are living with type 2 diabetes . In the UK, the incidence of type 2 diabetes in children aged <17 years was estimated to be 0.72/100 000 (95% CI 0.58‐0.88) in 2015/2016 …”

Personalized Cardio‐Metabolic Responses to an Anti‐Inflammatory Nutrition Intervention in Obese Adolescents: A Randomized Controlled Crossover Trial

“…Pediatric obesity is of major public health concern; one in three 11‐year‐old children in Europe are overweight or obese . Though the incidence of type 2 diabetes (T2D) in obese children and adolescents is rare, it is likely that the progressive decline in insulin sensitivity initiates in youth . Despite obesity, however, some adolescents maintain insulin sensitivity .…”