An analysis of national survey data found that the rates of childhood type 2 diabetes in the United States remained stable and low between 2016 and 2020, though small variations occurred across the 5-year period. The study examined behavioral, dietary, and neighborhood characteristics associated with disease severity among children aged 0 to 17 years, with a focus on early childhood (0 to 5 years).
Across 174,551 children surveyed, 0.5% had ever been diagnosed with type 2 diabetes (T2D), and 0.4% had the condition at the time of reporting. Among 49,546 children aged 0 to 5 years, the highest current T2D prevalence occurred in 2018 at 0.082%.
Significant associations appeared between disease severity and several community-level characteristics. In the full group of children aged 0 to 17-years, T2D severity was linked to the presence of neighborhood libraries or bookmobiles in 2016 and 2020, respectively, and the use of free or reduced-cost meal programs in 2017. In the 0 to 5-yearsubgroup, T2D was associated with neighborhood social support in 2016 and walkability in 2019.
Between 2019 and 2020, more families reported using assistance programs. Cash assistance rose from nearly 2.2% to 3.8%, Supplemental Nutrition Assistance Program (SNAP) participation from over 9.9% to 13.0%, and free or reduced-cost meal participation from about 19.8% to 23.3%. Reports of litter, garbage, and vandalism in neighborhoods also increased modestly during the same period.
Investigators analyzed weighted data from the National Survey of Children’s Health (NSCH) for 2016 to 2020. Parents or guardians reported whether a child had ever been diagnosed with T2D, currently had it, and how severe the condition was. To reduce misclassification, mild and moderate cases were combined into a single “nonsevere” category. Statistical analyses included chi-square tests and linear regressions to estimate yearly changes. Annual survey response rates ranged from approximately 37% to 43%.
In explaining the broader context of early-life risk, senior study author Lea Sacca, PhD, of the Charles E. Schmidt College of Medicine at the Florida Atlantic University, and colleagues wrote: “‘Western-like’ diets, defined by high levels of refined grains, savory snacks, animal fats, and sugar-containing beverages can be identified in children as young as 2 years of age and often carry on into lifelong dietary patterns.” The observation situated the study’s focus on how early nutritional environments may shape long-term metabolic health.
The investigators described the results as exploratory because all data relied on parent reports without clinical verification. The cross-sectional design limited the ability to establish causality or confirm disease type, and variations in survey response or sample composition could have affected prevalence estimates.
The investigators concluded that preventing childhood T2D should include addressing environmental and food access factors that influence children’s health. They emphasized the need for future studies to explore how neighborhood and social environments may contribute to early-life diabetes risk to better inform community-level interventions.
The authors reported no external funding and declared no competing interests.
Source: Pediatric Research
