What is pediatric diabetes?
Diabetes, also known as diabetes mellitus, is a metabolic disease. Diabetes is when there is too much sugar in the bloodstream. This occurs when the pancreas does not make enough or any insulin (called type 1 diabetes) or when the body’s cells do not respond to insulin (called type 2 diabetes).
Symptoms of diabetes include frequent urination, thirst, and hunger. Diabetes can be controlled by keeping blood sugar levels within a normal range, eating well, and being physically active. But uncontrolled diabetes can lead to blindness, kidney failure, heart disease, and amputation of toes, feet, and legs.
Visit the DPH Diabetes Prevention and Control’s What is diabetes? page for more information.
How does MA EPHT track pediatric diabetes?
Pediatric diabetes tracking is the ongoing collection of diabetes data from Massachusetts’ students each school year. Once collected, this data is also analyzed and interpreted. Data is collected using school health records. An annual survey is used to collect the records from approximately 1,800 schools serving students in Kindergarten through 8th grade.
Why does MA EPHT track pediatric diabetes?
Diabetes is on the rise worldwide. The collection of pediatric diabetes data began in 2008 as part of the pediatric asthma surveillance program in response to resident concerns of pediatric diabetes prevalence in specific communities in Massachusetts. We track pediatric diabetes data to learn how many cases there are in the state and which counties have a higher prevalence of diabetes than others (both type 1 and type 2). This enables us to look at diabetes trends over time and plan tailored public health interventions.
What is the relationship between diabetes and the environment?
Type 1
Type 1 diabetes is thought to be an autoimmune disease (when the body’s immune system mistakenly attacks its own health cells and tissues), but a clear cause is currently unknown. The presence of certain genes is known to increase the risk for type 1 diabetes. Studies have shown that many of these genes are involved with the body’s immune response, strengthening the understanding of type 1 diabetes as an autoimmune disease. The combination of these genes and environmental factors may trigger the immune system to destroy the cells in the pancreas that make insulin.
Environmental factors that can trigger the onset of type 1 diabetes have been extensively studied, but the findings are not conclusive. Research suggests possible association with viral infections (like enterovirus), high birth weight, high infant growth rate, childhood obesity, and changes in the gut microbiome. Additional research has examined dietary factors, such as the early introduction of certain foods (like cow’s milk and gluten), high intake of nitrates and nitrosamines (from processed meats or drinking water), and low prenatal intake of vitamin D. Psychological stress has also been studied.
People with an immediate family member (parent, sibling, or child) with type 1 diabetes are estimated to have a 1 in 20 chance of developing the condition. This is 15 times higher than the general population. However, 85% of diagnoses occur in people who have no family history.
Type 2
Type 2 diabetes also has a genetic basis. Scientists have identified more than 100 genes that play a role, but many are common in the general population. While genetics can make a person more likely to develop type 2 diabetes, it is not the sole cause. Rather, the combination of genes and environmental or lifestyle factors can trigger the onset.
Several lifestyle factors have consistently been shown to affect the risk of developing type 2 diabetes. Diets high in refined carbohydrates, saturated fats, and processed foods raise the risk while diets high in whole grain products and total fiber lower the risk. Smoking is a significant risk factor, with people who smoke being 30-40% more likely to develop the condition than those who do not. Being overweight or having a large waist size also increases the risk of developing type 2 diabetes. Risk is also linked to changes in the gut microbiome.
Studies show that environmental factors most likely to raise the risk of type 2 diabetes are outdoor air pollution (like particulate matter) and noise while walkability and green space are likely to lower risk. Other studiesalso suggests possible association with exposure to heavy metals (like arsenic, mercury, cadmium, and lead), persistent organic pollutants (like dioxin, PCBs, and chlorinated pesticides), and endocrine-disrupting chemicals (like bisphenol A [BPA], phthalates, and organochlorine pesticides).
Type 2 diabetes has a stronger link to family history than type 1 diabetes – but it is difficult to know whether this is due to genetics, shared environmental exposures, or similar lifestyle factors like eating and exercise habits.
Available data
Use the Explore Pediatric Diabetes Data link on this page to access the following measures:
- Pediatric diabetes counts and prevalence by geography. These measures are offered by county, EP Region, EOHHS Region and statewide.
Prevalence is used to measure the percentage of students with diabetes from that county that are enrolled in Massachusetts schools. The number of students with diabetes is reported by school nurses each school year. School nurses gather this information from the student’s school health records. They also use physician reports and parent information forms.
Pediatric diabetes prevalence estimates are compared to statewide prevalence. Doing so shows if the prevalence is statistically higher, lower, or about the same in the county as compared to the state. In some instances, counties may not be available in the MA EPHT Tool when the user is selecting data. This is because DPH does not have data available for that county in the year selected.
The most current available data will be shown. Be sure to check the site periodically as new data are added. To protect privacy, no information is shown that could potentially identify an individual.
Related links
Additional resources
Massachusetts
- DPH Diabetes management: Learn more about diabetes and the best ways to manage it after your diagnosis
- DPH Diabetes prevention: Learn more about diabetes prevention. If you have prediabetes, you can reverse it.
National
- American Diabetes Association (ADA): Information, tools, and resources to prevent and manage diabetes and equip health care professionals to enable those affected by diabetes to thrive and lead healthier, fuller lives
- Association of Diabetes Care and Education Specialists: Professional organization dedicated to advancing the quality of diabetes care and education
- CDC – About diabetes: Information about diabetes, including resources for health care providers such as a toolkit for diabetes self-management education and support (DSMES)
- The Environmental Determinants of Diabetes in the Young (TEDDY): An international study looking into the causes of type 1 diabetes
- Breakthrough T1D: Funds type 1 diabetes research to advance treatments, influence policy, and improve access to care
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Research and resources about diabetes, including the National Diabetes Information Clearinghouse