In 2018, nearly 27 million people in the United States had a diagnosis of diabetes and, of those, 210,000 were children and teens under age 20 (Centers for Disease Control and Prevention [CDC], 2020).
Over the last two decades, there has been a steady uptick in the percentage of children diagnosed with type I and II diabetes each year with an increase of about 1.9% since 2002 (CDC, 2020). All racial groups have been affected by the increase in prevalence, with Asian and Pacific Islanders (4.4% increase), Hispanic (4.0% increase), and Black (2.7% increase) patients having the sharpest jump in prevalence of either type of diabetes (CDC, 2020).
Currently, the prevalence among racial groups does also varies by type of diabetes. For type I diabetes, white children are most commonly affected, with 27.3 children per 100,000 having a diagnosis of type I diabetes. Black children follow closely behind with an incidence rate of 20.8 per 100,000 (CDC, 2020). Figure 1, directly from the CDC’s 2019 Diabetes Report Card, illustrates the incidence rates among other races as well.
Incidence of Type I Diabetes per 100,000 Persons Among Children and Adolescents Younger Than Age 20 Years, by Racial or Ethnic Group, United States, 2014–2015
Figure 2, also directly from the CDC’s 2019 Diabetes Report Card, illustrates the incidence of type II diabetes with racial distribution notably different. Incidence for type II diabetes is highest for Black children, with 37.8 of every 100,000 children having a diagnosis of type II diabetes. American Indians follow closely behind with an incidence of 32.8 per every 100,000. White children were affected the least at a rate of 4.5 children per every 100,000 (CDC, 2020).
Incidence of Type II Diabetes per 100,000 Persons Among Children and Adolescents Aged 10–19 Years, by Racial or Ethnic Group, United States, 2014–2015
Risk factors for developing diabetes varies depending on type of diabetes. Potential risk factors for type I diabetes are largely out of an individual’s control. These include (Mayo Clinic, 2021):
- Family history
- Viral exposure
- Presence of certain antibodies
Risk factors for type II diabetes includes (Mayo Clinic, 2021):
- Being overweight
- Low levels of physical activity
- Family history
- Black/Asian/or American Indian race/ethnicity
- Comorbid health conditions such as PCOS, hypertension, and hyperlipidemia
Exploration of these risk factors as well as genetics and the role of socioeconomic status (and associated accessibility to food) may all help scientists better understand the differences in incidence across racial and ethnic groups for both types of diabetes (CDC, 2020).
In addition to the primary health concern of regulating blood glucose levels and managing hypoglycemia and hyperglycemia and its symptoms, diabetes comes with a long list of long-term complications and possible disabilities. The most common long-term issues, that account for around $327 billion in United States healthcare costs annually, include (CDC, 2021):
- Cardiovascular disease
- Nerve damage
- Kidney damage
- Eye/retinal damage
- Foot problems
- Skin issues
- Hearing impairment
It is estimated that people with diabetes have annual healthcare costs 2.3 times higher than people without diabetes (American Diabetes Association [ADA], 2021). Dealing with chronic illness also affects work and school attendance, with over 34% of parents of diabetic children reporting an increase in the amount of school missed due to the disease when compared to peers without diabetes (Schwartz et al., 2010).
Annual deaths from pediatric diabetes are on the decline in recent years, with 265 children dying from complications of the disease in 2002 and a slightly lower 228 deaths in 2014. However, among those, the deaths of non-Hispanic Black children was about double that of non-Hispanic white peers (CDC, 2020).
The COVID-19 pandemic has also had an effect on the risks of complications from and new development of diabetes. People with diabetes are at an increased risk of experiencing serious complications and even death from COVID-19 illness, with poorer glycemic control related to poorer outcomes. There are also ongoing studies suggesting a correlation between COVID-19 infection and new onset diabetes in children under 18, implying the virus may cause subsequent autoimmune issues (ADA, n.d.).