Projections of Type 1 and Type 2 Diabetes Burden in the U.S. Population Aged &lt;20 Years Through 2050: Dynamic modeling of incidence, mortality, and population growth

Giuseppina Imperatore; James P. Boyle; Theodore J. Thompson; Doug Case; Dana Dabelea; Richard F. Hamman; Jean M. Lawrence; Angela D. Liese; Lenna L. Liu; Elizabeth J. Mayer-Davis; Beatriz L. Rodriguez; Debra Standiford; for the SEARCH for Diabetes in Youth Study Group

doi:10.2337/dc12-0669

Original Research

Projections of Type 1 and Type 2 Diabetes Burden in the U.S. Population Aged <20 Years Through 2050

Dynamic modeling of incidence, mortality, and population growth

Giuseppina Imperatore, MD, PHD¹ ⇓,
James P. Boyle, PHD¹,
Theodore J. Thompson, MS¹,
Doug Case, PHD²,
Dana Dabelea, MD, PHD³,
Richard F. Hamman, MD, DRPH³,
Jean M. Lawrence, SCD, MPH, MSSA⁴,
Angela D. Liese, PHD⁵,⁶,
Lenna L. Liu, MD, MPH⁷,
Elizabeth J. Mayer-Davis, PHD⁸,⁹,
Beatriz L. Rodriguez, MD, PHD¹⁰,¹¹,
Debra Standiford, CNP¹²,
for the SEARCH for Diabetes in Youth Study Group

¹Division of Diabetes Translation, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia
²Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
³Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, Colorado
⁴Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
⁵Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, South Carolina
⁶Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina
⁷Seattle Children’s Hospital, Seattle, Washington
⁸Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina, Chapel Hill, North Carolina
⁹Department of Medicine, Gillings School of Global Public Health and School of Medicine, University of North Carolina, Chapel Hill, North Carolina
¹⁰Kuakini Medical Center, Honolulu, Hawaii
¹¹University of Hawaii School of Medicine, Honolulu, Hawaii
¹²Division of Endocrinology, Children's Hospital Medical Center, Cincinnati, Ohio

Corresponding author: Giuseppina Imperatore, gimperatore{at}cdc.gov.
Received 6 April 2012 and accepted 4 September 2012.

Diabetes Care 2012 Dec; 35(12): 2515-2520. https://doi.org/10.2337/dc12-0669

Abstract

OBJECTIVE To forecast the number of U.S. individuals aged <20 years with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) through 2050, accounting for changing demography and diabetes incidence.

RESEARCH DESIGN AND METHODS We used Markov modeling framework to generate yearly forecasts of the number of individuals in each of three states (diabetes, no diabetes, and death). We used 2001 prevalence and 2002 incidence of T1DM and T2DM from the SEARCH for Diabetes in Youth study and U.S. Census Bureau population demographic projections. Two scenarios were considered for T1DM and T2DM incidence: 1) constant incidence over time; 2) for T1DM yearly percentage increases of 3.5, 2.2, 1.8, and 2.1% by age-groups 0–4 years, 5–9 years, 10–14 years, and 15–19 years, respectively, and for T2DM a yearly 2.3% increase across all ages.

RESULTS Under scenario 1, the projected number of youth with T1DM rises from 166,018 to 203,382 and with T2DM from 20,203 to 30,111, respectively, in 2010 and 2050. Under scenario 2, the number of youth with T1DM nearly triples from 179,388 in 2010 to 587,488 in 2050 (prevalence 2.13/1,000 and 5.20/1,000 [+144% increase]), with the greatest increase in youth of minority racial/ethnic groups. The number of youth with T2DM almost quadruples from 22,820 in 2010 to 84,131 in 2050; prevalence increases from 0.27/1,000 to 0.75/1,000 (+178% increase).

CONCLUSIONS A linear increase in diabetes incidence could result in a substantial increase in the number of youth with T1DM and T2DM over the next 40 years, especially those of minority race/ethnicity.

Footnotes

This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc12-0669/-/DC1.
A slide set summarizing this article is available online.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official positions of the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases.
See accompanying commentary, p. 2417.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

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