Type 2 Diabetes Overtakes Type 1 Diabetes in Young People

A new study by researchers at Providence Health Care (PHC) shows Type 2 diabetes has drastically increased in people under 30, even surpassing Type 1 diabetes.

The study, titled Diabetes in the young: A population-based study of South Asian, Chinese, and White people, found that the majority of young people under 30 with diabetes have Type 2 diabetes. In White youth with diabetes, 62 per cent have Type 2, among South Asian youth that number increases to 86 per cent, and among Chinese youth it is 87 per cent.

“Although this study did not look at causes of diabetes in the young, the rising rates of obesity, highcalorie, high-sugar content diets, and increased sedentariness are likely the root causes of this surge in Type 2 diabetes in those under 30,” said senior author Dr. Nadia Khan, a researcher with the Centre for Health Evaluation and Outcome Sciences (CHÉOS) at PHC and an Associate Professor at the University of British Columbia (UBC) Faculty of Medicine.

Researchers also uncovered alarming findings about rates of Type 2 diabetes cases, especially for South Asians, who had higher incidences of Type 2 diabetes compared with both Chinese and White people. In those aged 20 to 29, new cases of Type 2 diabetes were 2.2 times higher in South Asians than in White people and 3.1 times higher in South Asians compared with Chinese people. “South Asians are three to five times more likely to develop Type 2 diabetes than the general population,” said Dr. Parmjit Sohal, co-author and Clinical Associate Professor in the UBC Department of Family Practice. “This study suggests that this increased risk of Type 2 diabetes may begin as early as age 20.”

Type 2 diabetes, caused mostly by obesity and physical inactivity, has generally been considered a disease of older adults, typically occurring in people 35 years and older. Although the rates for youth remain much lower than in older patients, Type 2 diabetes is a growing health problem, doubling the risk of heart disease, kidney disease, and a significant risk factor for early death. Previous studies have shown that younger people are experiencing rapid increases in cases of Type 2 diabetes—45 per cent of new diabetes cases in adolescents are Type 2; this is compared to 3 per cent 20 years ago.

“Over the last few decades, lifestyles have changed dramatically. Many now live in urbanized environments where people are generally less active, and eat more high-calorie foods. These  changes have led to an astounding increase of young people with diabetes,” said Dr. Calvin Ke, first author and a resident in Internal Medicine at St. Paul’s Hospital. “We need to act urgently to prevent diabetes in young people.”

Type 2 diabetes can be controlled and prevented, or at least delayed, with proper nutrition and exercise. The researchers believe these increased rates in youth are a signal that we need to encourage healthy lifestyles beginning in childhood in order to prevent these diseases.

“Current Clinical Practice Guidelines recommend that screening for Type 2 diabetes should start at age 40 in the general population,” said Dr. Khan. “This study suggests that screening for Type 2 diabetes in high-risk South Asians may need to start at younger ages.”

The study, published in Diabetic Medicine, identified 712 South Asian, 498 Chinese and 6,176 “White” (mainly Caucasian, with few from Aboriginal and minority groups) people in British Columbia under the age of 30 with diabetes. Drs. Khan, Ke, and Sohal were joined by co-authors Hong Qian (CHÉOS), and Dr. Hude Quan (University of Calgary). There are currently about 3 million Canadians living with diabetes. The study was funded by the Canadian Institutes of Health Research, and Dr. Khan is a Michael Smith Foundation for Health Research Scholar.

About Diabetes:
There are about 382 million people with diabetes in the world and this number is estimated to increase to 592 million by 2035. Canada, with a population of about 35 million, has about 3 million people with diabetes. Diabetes is one of the leading causes of heart attack, stroke, kidney failure, adult blindness, and non-traumatic limb amputations in Canadian adults. Several studies have shown that Type 2 diabetes can be prevented or delayed by intensive life style interventions, including a healthy diet and regular exercise. Primary prevention of diabetes is of paramount importance to reduce the burden of diabetes and its complications.

About Providence Health Care:
Providence Health Care (PHC) is one of Canada's largest faith-based health care organizations, operating 16 health care facilities in Greater Vancouver. PHC operates one of two adult academic health science centres in the province – St. Paul’s Hospital – performs cutting-edge research in more than 30 clinical specialties, and focuses its services on six “populations of emphasis”: cardiopulmonary risks and illnesses, HIV/AIDS, mental health, renal risks and illness, specialized needs in aging, and urban health, and is home to the B.C. Centre for Excellence in HIV/AIDS.

About the Centre for Health Evaluation and Outcome Sciences:
A centre of the Providence Health Care Research Institute and the University of British Columbia, the Centre for Health Evaluation and Outcome Sciences (CHÉOS) is an inter-disciplinary research collective founded to pursue excellence through the evaluation, interpretation, and communication of health outcomes research. CHÉOS works across all of PHC Research Institute's health disciplines, including aging, cardiopulmonary health, urban health, HIV/AIDS, mental health, and kidney health.