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The treatment of type 1 diabetes in children and youth

Published on May 22, 2013   53 min

A selection of talks on Metabolism & Nutrition

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0:00
I will discuss the treatment of type 1 diabetes in children and youth.
0:06
I'm the Chief Medical Officer of Medtronic Diabetes.
0:11
This is an outline of my talk. First, I'll discuss the screening, prevention, and early interdiction of the type 1 process, and ask the question, can this actually be accomplished? Next, I'll discuss the diagnosis of type 1 diabetes and what tests should be done to assure that a child does have type 1 versus type 2 diabetes. Treating type 1 diabetes Asking the question, is intensive management now the standard of care? And of course, emphasizing the importance of being aware of the co-morbidities of this disease. Then finally, I'll conclude with the cure and discuss the first automated function and then the dream of a full artificial pancreas.
0:52
This slide shows the results of The SEARCH trial which has been done in multiple centers in the United States. It shows that the overall prevalence rate is 1.8 cases per 1000 youth, approximately about 160 or 170,000 children now in the country with this disease. There are about 16,000 new cases of type 1 per year and 3800 new cases of type 2 diabetes per year. On the left, zero to nine years of age has a prevalence rate of about 0.8 per 1000. The different races and ethnicities from Non-Hispanic White, African American, Hispanic, Asian Pacific Islander, and American Indian youth. In those zero to nine years of age, almost all the diabetes is due to type 1 diabetes compared to type 2 or other form of diabetes. It turns out that, however, even in American Indian youth in this young age range, there's now starting to be an increase in those who have type 2 diabetes. On the right side, you can see the children of 10 to 19 years of age, and that the prevalence rate is much higher at 2.8 per 1000. Again, across the different races and ethnicities, I think you can see now that of those who do have diabetes in African American, Hispanic, and Asian Pacific Islander youth, about a third actually have type 2 diabetes. For American Indians, it's almost two-thirds that have type 2 compared to type 1. But please note that in the Non-Hispanic White youth, the predominant is type 1 diabetes, and less than 8% actually have type 2. The bottom shows that there has been an increase in type 1 per year, about 3% per year. And in those very young children, it's about 5% per year. This compares to about a 10-fold increase in type 2 diabetes over the last decade.

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The treatment of type 1 diabetes in children and youth

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