Type 2 diabetes among North American children and adolescents: An epidemiologic review and a public health perspective

Objectives: To review the magnitude, characteristics, and public health imp ortance of type 2 diabetes in North American youth. Results: Among 15- to 19-year-old North American Indians, prevalence of typ e 2 diabetes per 1000 was 50.9 for Pima Indians, 4.5 for all US American In dians, and 2.3 for Canadian Cree and Ojibway Indians in Manitoba. From 1967 -1976 to 1987-1996, prevalence increased 6-fold for Pima Indian adolescents . Among African Americans and whites aged 10 to 19 years in Ohio, type 2 di abetes accounted for 33% of all cases of diabetes. Youth with type 2 diabet es were generally 10 to 19 years old, were obese and had a family history o f type 2 diabetes, had acanthosis nigricans, belonged to minority populatio ns, and were more likely to be girls than boys. At follow-up, glucose contr ol was often poor, and diabetic complications could occur early. Conclusions: Type 2 diabetes is an important problem among American Indian and First Nation youth. Other populations have not been well studied, but c ases are now occurring in all population groups, especially in ethnic minor ities. Type 2 diabetes among youth is an emerging public health problem, fo r which there is a great potential to improve primary and secondary prevent ion.