Diabetes in Youth

The SEARCH for Diabetes in Youth multicenter study, funded by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), has determined that

• based on data from 2002 to 2003, a total of 15,000 youth in the United States were newly diagnosed with type 1 diabetes each year. In addition, about 3,700 youth were newly diagnosed with type 2 diabetes each year.
• non-Hispanic white youth had the highest rate of new cases of type 1 diabetes.
• type 2 diabetes was rarely diagnosed among youth younger than 10 years of age

Additional information about specific rates of new cases of type 1 and type 2 diabetes among youth younger than age 20 can be found in the fact sheet National Diabetes Statistics, 2007

Other Types of Diabetes

A number of other types of diabetes exist. A person may exhibit characteristics of more than one type. For example, in latent autoimmune diabetes in adults (LADA), also called type 1.5 diabetes or double diabetes, people show signs of both type 1 and type 2 diabetes.

Other types of diabetes include those caused by

• genetic defects of the beta cell—the part of the pancreas that makes insulin—such as maturity-onset diabetes of the young (MODY) or neonatal diabetes mellitus (NDM)
• genetic defects in insulin action, resulting in the body’s inability to control blood glucose levels, as seen in leprechaunism and the Rabson-Mendenhall syndrome
• diseases of the pancreas or conditions that damage the pancreas, such as pancreatitis and cystic fibrosis
• excess amounts of certain hormones resulting from some medical conditions—such as cortisol in Cushing’s syndrome—that work against the action of insulin
• medications that reduce insulin action, such as glucocorticoids, or chemicals that destroy beta cells
• infections, such as congenital rubella and cytomegalovirus
• rare immune-mediated disorders, such as stiff-man syndrome, an autoimmune disease of the central nervous system
• genetic syndromes associated with diabetes, such as Down syndrome and Prader-Willi syndrom

Latent Autoimmune Diabetes in Adults (LADA)

People who have LADA show signs of both type 1 and type 2 diabetes. Diagnosis usually occurs after age 30. Researchers estimate that as many as 10 percent of people diagnosed with type 2 diabetes have LADA. Some experts believe that LADA is a slowly developing kind of type 1 diabetes because patients have antibodies against the insulin-producing beta cells of the pancreas.

Most people with LADA still produce their own insulin when first diagnosed, like those with type 2 diabetes. In the early stages of the disease, people with LADA do not require insulin injections. Instead, they control their blood glucose levels with meal planning, physical activity, and oral diabetes medications. However, several years after diagnosis, people with LADA must take insulin to control blood glucose levels. As LADA progresses, the beta cells of the pancreas may no longer make insulin because the body’s immune system has attacked and destroyed them, as in type 1 diabetes.

Diabetes Caused by Genetic Defects of the Beta Cell

Genetic defects of the beta cell cause several forms of diabetes. For example, monogenic forms of diabetes result from mutations, or changes, in a single gene. In most cases of monogenic diabetes, the gene mutation is inherited. In the remaining cases, the gene mutation develops spontaneously. Most mutations in monogenic diabetes reduce the body’s ability to produce insulin. Genetic testing can diagnose most forms of monogenic diabetes.

NDM and MODY are the two main forms of monogenic diabetes. NDM is a form of diabetes that occurs in the first 6 months of life. Infants with NDM do not produce enough insulin, leading to an increase in blood glucose. NDM can be mistaken for the much more common type 1 diabetes, but type 1 diabetes usually occurs after the first 6 months of life. More information about the two types of NDM, permanent neonatal diabetes and transient neonatal diabetes mellitus, is provided in the fact sheet Monogenic Forms of Diabetes, available online from the NDIC at www.diabetes.niddk.nih.gov/dm/pubs/mody. For printed copies of the fact sheet, call the NDIC at 1–800–860–8747.

MODY usually first occurs during adolescence or early adulthood. However, MODY sometimes remains undiagnosed until later in life. A number of different gene mutations have been shown to cause MODY, all of which limit the pancreas’ ability to produce insulin. This process leads to the high blood glucose levels characteristic of diabetes. More information about specific types of MODY is provided in the fact sheet Monogenic Forms of Diabetes.