Type 1 Still on the Rise in US Kids

written by Sarah Howard
Coordinator of the Diabetes-Obesity Spectrum Working Group

You may have seen the recent articles about the CDC data that found that type 2 diabetes incidence has recently started to decline in the US (e.g., New diabetes cases, at long last, begin to fall in the United States). That New York Times article notes that, “Type 1 diabetes, often diagnosed in childhood and adolescence and not usually associated with excess body weight, was also included in the data.”

Well, there has been a lot of talk about CDC data relating to type 1 diabetes. While it is technically true that type 1 diabetes is “included” in the CDC numbers, the CDC data do not tell us anything about type 1 diabetes. Since type 2 makes up about 90-95% of diabetes cases in the US, and the CDC does not distinguish between type 1 and type 2 diabetes, the CDC data do not tell us if type 1 is increasing or not.

A new Medpage Today article notes that a new study finds that type 1 prevalence increased between 2002-2013 in US children: Type 1 diabetes prevalence on the rise in kids: group complains about reports that lump type 1 together with type 2 (See the study: Prevalence of diabetes and diabetic nephropathy in a large US commercially insured pediatric population, 2002–2013.)

Type 2 in children increased until 2006 and then began to fall. Thus the two types do not show the same pattern in the population, and should not be lumped together.

This study also finds that diabetic nephropathy is also increasing in children, starting at age 12.

Other data, from the SEARCH for Diabetes in Youth study, also continue to find type 1 increasing in US children.

And almost no one is looking at type 1 incidence in US adults.

NHANES also does not distinguish between type 1 and type 2 diabetes, making it difficult for researchers to analyze whether or not chemicals play a role in type 1 diabetes. Type 1 diabetes is an autoimmune disease that often is diagnosed during childhood. Type 2 diabetes is associated with insulin resistance and obesity. We cannot assume that these separate processes have identical or even similar responses to chemical or other environmental exposures.

Type 1 diabetes incidence in children is increasing in at least 61 countries/regions worldwide. To see these studies or more on diabetes incidence/prevalence in the US and around the world, see Diabetes Incidence and Historical Trends

Thin Places: Providing Space to Explore the Complexity of Health and the Environment

written by Elise Miller, EdM
Director 

Thin Places, a book written by Ann Armbrecht, an anthropologist friend who completed her doctoral research in northeastern Nepal in the 1990s, explores what it means for people to live close to the land–and how that, in turn, fosters greater intimacy with every other relationship in our lives and shapes our sense of home. In the tribal region Armbrecht studied, the people seemed to live with a stronger sense of connection to the natural world and to community. The conceptual walls often imposed by Western cultures between humans and the environment seemed thinner for those in this region–more permeable and multi-faceted.

Whether we choose to recognize it or not,  the fact is we all live in thin places. Forward thinking segments of industrialized world now acknowledge that the boundaries and distinctions we have defined over centuries, whether between academic departments or cultural norms or forms of healing, are not so neatly segregated. Instead, what contributes to our health and well-being is far more complex and nuanced than we ever imagined. This of course raises more questions than answers. We can no longer retreat into our polarized perspectives. With emerging information and insights, we are instead forced to question our assumptions again and again.

Yet there are few forums where open discussion on these complex issues and concerns can take place. This is why CHE is valued by so many around the world. CHE insists on civil, constructive, non-polarizing conversations on our highly regarded teleconferences and our multiple listservs. The vast majority of responses to our recent surveys indicate that CHE’s services would be sorely missed if they were no longer available. Many indicated that CHE is deeply important to them–it enriches their professional and personal lives in ways that no other organization in the environmental health sector does.

In other words, CHE is a place where you can talk about thin places. The places that are not so clearly defined, but essential to ponder regularly with colleagues if we are to have a healthier future.

Your support now will ensure that these critical conversations continue to take place so that we can collectively implement the most effective, well-informed, and prevention-oriented strategies possible. We recognize there are many organizations worthy and deserving of your support, but given what CHE uniquely provides in the environmental health field, please make a tax-deductible gift to CHE today.

Warmest wishes for the holidays and deep gratitude for your partnership in this effort,

Elise