The public health epidemiology of type 2 diabetes in children and adolescents: a case study of American Indian adolescents in the Southwestern UnitedStates

Type 2 diabetes among children and adolescents is a newly recognized diseas e in the United States. Because obesity and physical inactivity are increas ing in children and adolescents, the prevalence of pediatric type 2 diabete s may increase and eventually become an important cause of adult morbidity and mortality. Data on type 2 diabetes in adolescents aged 15-19 years were compared between two sources: systematic population screening of the Gila River Indian Community by the National Institutes of Health (NM), and repor ted cases by the Indian Health Service (MS) from clinics in the Southwester n US. The current NM estimate of prevalence of type 2 diabetes was much hig her than the Ms estimate (5.1% vs. 0.46%). Both data sources, however, sugg est a secular increase in prevalence between 1986 and 1996-97. These data a re used to discuss the principles, applications, and challenges for accurat e epidemiologic assessment of type 2 diabetes in children and adolescents. (C) 1999 Elsevier Science B.V. All rights reserved.