Section 4A - Study Objectives/Background and Significance (Phase 3 - 11/2010)
Section 4A - Page 11
Registry
Study
Between 1990 and 2002, average annual rises were 23% in the indigenous, and 31% in
the non-indigenous population.
With the exception of SEARCH, only a limited number of population-based studies of
childhood T2D exist. Most have been conducted in American Indians and Native
Canadians
(78, 86 - 87)
and showed high prevalence of T2D. While there is evidence
supporting an increasing incidence and prevalence of T2D among youth, it is possible
that this rise is mainly a feature of high-risk ethnic groups. Well-designed studies of
youth in Germany, Austria, France and the U.K
(88 - 90)
all indicate that T2D remains a
rarity in these populations, accounting for only 1-2% of all diabetes cases. A survey of
all children with diabetes from 177 U.K. pediatric diabetes centers found that <1% of all
cases were due to T2D
(91)
. A single center in France
(89)
reported that only 2% of 382
children (aged 1-16) with diabetes had T2D. Using an Austrian national register, Rami et
al
(92)
found that T2D represented only 1.5% of all newly diagnosed cases of diabetes
under the age of 15 from 1999-2001. In contrast, while the SEARCH data
(5)
support the
notion that T2D in youth is predominantly occurring in high risk ethnic groups, T2D
accounts for 14.9% of all diabetes cases among NHW adolescents age 10 years and older.
Although differences in obesity rates between U.S. and European youth are likely
contributors, the full explanation for these discrepancies remains uncertain and deserves
further study. By continuing to ascertain prospectively newly diagnosed diabetes cases,
SEARCH will be in the unique position to estimate trends in the incidence of T2D among
US youth by age-group, sex and race/ethnicity.
4.3.
PUBLIC HEALTH SURVEILLANCE OF DIABETES IN YOUTH
4.3.1.
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