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Child diabetes rates steady – for now

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Children as young as seven years are being diagnosed with type 2 diabetes, but there is as yet no evidence that its incidence among the young is increasing despite rising rates of overweight and obesity.

In a result that does not sit easily with evidence of the nation’s swelling waistline, the Australian Institute of Health and Welfare has reported that the incidence of type 2 diabetes among those aged between 10 and 39 years was largely unchanged in the 10 years to 2011-12, aside from a decline among 20 to 29-year-olds.
According to data analysed by the Institute in Type 2 diabetes in Australia’s children and younger people: a working paper, each year on average around 150 children and adolescents aged between 10 and 19 years were diagnosed with type 2 diabetes.

Consistent with evidence that type 2 diabetes is predominantly a disease of the middle aged and elderly, the AIHW found that 92 per cent of diagnoses were among people aged 40 years and older, and that the incidence in this age group was 441 per 100,000, compared with just 3 per 100,000 among 10 to 14-year-olds.

But the Institute said the relatively low incidence of type 2 diabetes in the young (type 1 diabetes is much more common in children, accounting for 88 per cent of diabetes cases diagnosed in children aged 10 to 14 years) was no cause for complacency, for a number of reasons.

For one, though the number of young people with the disease was small, where it did occur its effects were typically more severe, the risk of complications was greater, treatment was more difficult and complicated, and the lifetime costs – in terms of treatment, reduced capacity to study and work, reduced life expectancy – were higher than for those who contracted the condition later in life.

Related to this, its incidence among Indigenous children was far higher than in the broader community. In its analysis, the AIHW found that Indigenous children aged between 10 and 14 years were eight times more likely to have type 2 diabetes than their non-Indigenous peers, while among Indigenous 15 to 19-year-olds the incidence was four times greater.

Secondly, the behaviour that increases the risk of developing type 2 diabetes – poor diet and a sedentary lifestyle – has become increasingly common, as indicated by the rise in rates of overweight and obesity among children.

Thirdly, the Institute warned that existing data was likely to underestimate the incidence and prevalence of type 2 diabetes among the young because of estimates that about 25 per cent of people with the disease are undiagnosed, and the difficulty of distinguishing between type 1 and type 2 diabetes in children and adolescents.

In its Working Paper, the AIHW argued that it was important to monitor the incidence of type 2 diabetes in children and young people because of its severe lifelong effects and costs, the increase in risk factors, and the likelihood that it had so far been underreported.
“It is thought that the increased rates of obesity in young people will impact on type 2 diabetes, with greater numbers developing the disease at younger ages,” the Institute said.

It said that, despite its limitations, the information examined in the Working Paper provided a baseline against which future monitoring readings could be assessed.
“There is scope to improve Australia’s ability to monitor type 2 diabetes in children and young people, and to prevent this serious disease and its complications among young people,” the Working Paper said.

Adrian Rollins

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