What is pediatric diabetes?
Diabetes, also known as diabetes mellitus, is a metabolic disease where there is too much sugar in the bloodstream because the body cannot produce enough insulin, the body produces no insulin, or because the body's cells do not respond to insulin. It is not a contagious disease. There are 2 types of diabetes in children, type 1 and type 2. With diabetes, the blood sugar rises and can cause polyuria (frequent urination), polydipsia (increasing thirst), and polyphagia (increasing hunger). Diabetes can be controlled by keeping blood sugar levels within a normal range, eating well, and being physically active. However, when diabetes is poorly controlled, it can lead to blindness, kidney failure, heart disease, and amputation of toes, feet, and legs.
What is type 1 diabetes?
Type 1 diabetes used to be more commonly known as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. It is usually brought on suddenly as the body stops making insulin. While the disease can develop at any age, type 1 diabetes is diagnosed more often in children and young adults and makes up the majority of diabetes diagnoses in children. It is thought to be an autoimmune disease or triggered by a virus, but a clear cause is currently unknown. Possible risk factors for type 1 diabetes include genetics and environmental exposures. Type 1 diabetes is usually controlled with insulin injections, diet, and exercise. People with type 1 diabetes need to take insulin for the rest of their life.
Between 2002 and 2018, the incidence, or new cases, of type 1 diabetes in people from birth to 19 years of age rose significantly in the U.S, increasing by about 2% each year1. Type 1 diabetes occurs equally among males and females but is more common in whites than in nonwhites. The World Health Organization's Multinational Project for Childhood Diabetes indicates that type 1 diabetes is rare in most African, American Indian, and Asian populations but some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes.
1. Wagenknecht LE, Lawrence JM, Isom S, et al. Trends in incidence of youth-onset type 1 and type 2 diabetes in the USA, 2002-18: results from the population-based SEARCH for Diabetes in Youth study. Lancet Diabetes Endocrinol. 2023;11(4):242–250. doi: 10.1016/S2213-8587(23)00025-6
What is type 2 diabetes?
Type 2 diabetes comes on more slowly than type 1 diabetes and is more commonly diagnosed in people 45 years of age or older who are overweight. Among adults, type 2 diabetes is by far the most common type, making up approximately 90 to 95% of all cases. However, individuals can be diagnosed with type 2 diabetes at any age, and it is increasingly being diagnosed in younger populations. With type 2 diabetes, the body does not make enough insulin or cannot use the insulin that it makes. Genetics and environmental causes can play a role in the development of type 2 diabetes. Treatment for people with type 2 diabetes includes insulin pills or injections, healthy eating, and increased physical activity.
How does MA EPHT track pediatric diabetes?
Pediatric diabetes tracking, or surveillance, is the ongoing collection, analysis, and interpretation of diabetes data in a population of students. The Massachusetts Department of Public Health/Bureau of Climate and Environmental Health (MDPH/BCEH) elected to track diabetes in 2008 following the success of the pediatric asthma surveillance program. This program tracks the occurrence of diabetes through school health records in students who are enrolled in approximately 1,800 public, charter, and private schools serving Kindergarten through 8th grade using an annual survey.
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 due to resident concerns of pediatric diabetes prevalence in specific cities and towns in Massachusetts. MDPH/BCEH tracks pediatric diabetes data to learn how much diabetes exists in the state and which counties have a higher prevalence of diabetes than others (both type 1 and type 2). This enables the MDPH/BCEH to look at diabetes trends over time and plan targeted public health interventions.
What is the relationship between diabetes and environmental factors?
Type 1 diabetes is diagnosed more often in children and young adults whereas type 2 diabetes is more prevalent in adults but can occur in children. Type 1 is thought to be an autoimmune disease or triggered by a virus, but a clear cause is currently unknown. The presence of certain genes is known to increase risk for type 1 diabetes. However, research suggests that in the case of identical twins, if one twin has type 1 diabetes, the other twin may get the disease only half the time at most. Environmental causes of type 1 diabetes may be related to diet such as the early or late introduction of certain foods (e.g., cow’s milk, dietary gluten, or vitamin D) and drinking water that contains nitrates or may be related to the perinatal period of development. Viral infections such as congenital rubella virus and human enteroviruses (e.g., coxsackie) which can infect the beta cells of the pancreas have been hypothesized as possible causes. An increase in psychological stress has also been suggested as an environmental cause.
Type 2 diabetes also has a genetic basis with the likelihood of the disease being approximately 3 in 4 for identical twins if their twin sibling is diagnosed with type 2 diabetes. Research into the role of Persistent Organic Pollutants (POPs) (e.g., dioxin, PCBs, chlorinated pesticides, etc.) suggests a possible association between exposure to POPs and diabetes in adults, but little research has been conducted on children to date. POPs may alter insulin action; however, a specific mechanism is not known. Air pollution, specifically exposure to particulate matter (PM2.5), may contribute to diabetes prevalence in adults but no information exists for children at this time. According to the American Diabetes Association, being overweight is a risk factor for developing type 2 diabetes, but other risk factors related to family history, ethnicity, and age can also play a role.
Available data on pediatric diabetes
Use the Explore Pediatric Diabetes Data button at the top of this page to access the following measures for pediatric diabetes in your county. Prevalence is the statistic used to measure the amount of pediatric diabetes in each school or county. Prevalence is presented per 1,000 students and confidence intervals shown indicate the precision of the prevalence estimate. Prevalence in counties is defined as the percentage of students who are residents of the county and enrolled in a Massachusetts public, charter, or private school reported by school nurses to have diabetes during a school year. School nurses gather this information from the student’s school health record, physician reports, and parent information forms. For each year of data available, pediatric diabetes prevalence estimates are compared to statewide prevalence to determine if they are statistically significantly higher, lower, or the same as the statewide pediatric diabetes prevalence.
- Pediatric diabetes counts and prevalence by geography (county, EP Region, EOHHS Region and statewide)
The most current available data will be shown. Be sure to check the site periodically as new data are added each year. To protect privacy, no information is shown that could identify an individual.