What is the youngest age to get diabetes?

Black and Mexican American adults develop diabetes at a younger age

Certain racial and ethnic minorities develop type 2 diabetes at a younger age than white Americans, meaning current diabetes screening and prevention practices for them may be inadequate and inequitable, reports a new Northwestern Medicine study.

American adults are diagnosed with type 2 diabetes at an average age of 50 years old, but the 3,022-participant study found the average age at diagnosis was four to seven years earlier in non-Hispanic Black and Mexican American adults compared with non-Hispanic white adults. More than 25% of non-Hispanic Black and Mexican American adults with diabetes reported a diagnosis before turning 40.

The study was published today, Sept. 7, in the journal JAMA Internal Medicine.

Knowing when certain populations typically get diagnosed with a disease can help inform when doctors start screening to implement treatments that can slow or stop progression of the disease. Those screenings are covered under insurance plans when they are recommended by the U.S. Preventive Services Task Force (USPSTF), the national independent panel of experts that systematically reviews evidence to develop recommendations for clinical preventive services.

“The earlier you can screen, the better, but the biggest barrier to screening is the tradeoff for cost and benefit. Screening too early when a disease is not prevalent is not cost effective,” said corresponding author Dr. Sadiya Khan, assistant professor of medicine and of preventive medicine at Northwestern University Feinberg School of Medicine. “The earlier you identify disease can make screening have the most impact when intervention may have greater benefit. Not doing so may contribute to substantial disparities in diabetes outcomes.”

Burden of diabetes has shifted earlier in the lifespan

Preventive measures such as nutrition counseling, weight-loss and physical-activity programs and the Centers for Disease Control and Prevention’s National Diabetes Prevention Program can prevent or delay the onset of diabetes. The study findings suggest that greater prevention efforts are needed at younger ages in underserved communities to help narrow the gap in age at diabetes diagnosis, said first study author Michael Wang.

“Sixteen percent of non-Hispanic Black and 21% of Mexican American adults with diabetes reported a diagnosis before 35 years old in our study, which suggests that reaching young adults in these groups for preventive care is needed to address a critical period when diabetes is developing,” said Wang, a fourth-year medical student at Feinberg.

The findings also highlight the need to recognize and address how social determinants of health – the economic and social conditions that influence individual and group differences in health status – lead to increased risk among minority populations and reflect an underlying health inequity, the study authors said.

20% people with diabetes don’t know they have it

The study was a cross-sectional analysis of data from the National Health and Nutrition Examination Survey from 2011 to 2018. This survey provides population-level data on age at the time of diagnosis in those who are aware of their diagnosis, but about 20% of people with diabetes do not know they have the disease, Wang said, which is why it is important to implement broader screening at younger ages.

The USPSTF recently announced new guidelines that lowered the recommended age from 40 to 35 to start screening adults with overweight or obesity for type 2 diabetes. Future research should consider whether even earlier screening is indicated among individuals with exposure to social risks, the study authors said.

“Unless your blood sugar climbs to an alarming level where you’re experiencing fatigue, frequent urination and symptoms of hyperglycemia, your diabetes may remain undetected for quite a while,” Khan said.

To screen for diabetes, doctors most commonly administer a blood test known as a hemoglobin A1C (HbA1c) test, which measures a person’s average blood sugar levels over the prior three months. Less than 5.7% HbA1c is normal; 5.7-6.4% is prediabetic and 6.5% is diabetic.

“We, as physicians, are always telling people to ‘know your numbers,’ which has historically been about blood pressure and cholesterol, but it should be expanded to include HbA1C,” Khan said.

Other Northwestern co-authors include Dr. Nilay Shah, Professor Mercedes Carnethon and Dr. Matthew O’Brien.

Does my child have diabetes?

“Most of the food we eat is broken down into sugar, or glucose, which our bodies use for energy,” said Samina Yousuf, MD, a pediatrician at OSF HealthCare. “When sugar enters your bloodstream, your pancreas produces insulin, which acts like a key that allows the cells in your body to put that glucose to work.

Signs of Diabetes.

“However, if a person has Type 1 diabetes, their body has stopped producing insulin. If they have Type 2, their body has become resistant to insulin and doesn’t react to it the way that it should. Left untreated, diabetes can lead to numerous health problems, including heart disease, kidney disease, vision problems, nerve damage and even death.”

Who does it impact?

Type 1 diabetes usually occurs in children and young adults and is typically thought to be caused when the body’s immune system mistakenly attacks the insulin-producing cells within the pancreas. Type 2 usually develops in adults who are over 40 years old or overweight, but it’s becoming more common in children due to increased obesity rates.

Children diagnosed with Type 1 or Type 2 diabetes are usually around 13-14 years old, but a diagnosis for Type 1 can come much earlier.

What are the symptoms?

“Type 1 and Type 2 diabetes share the same symptoms, but they typically differ in how quickly those symptoms appear,” Dr. Yousuf said. “Type 1 symptoms in children usually happen suddenly – like over the course of a few hours or days. On the other hand, Type 2 symptoms tend to appear gradually over the course of a few years.”

Key symptoms to watch for:

Seeing signs in your child?

• Extreme fatigue
• Feeling hungry despite eating
• Increased thirst
• Frequent urination (including bed wetting by potty-trained kids)
• Weight loss without trying
• Fruity smelling breath
• Irritability or behavior changes
• Blurry vision
• Cuts or bruises that heal slowly
• Very dry skin
• Tingling, pain or numbness in the hands or feet
• Belly (abdominal) pain
• Nausea

Actions for parents to take

“If you notice any of these symptoms in your child, it’s important to call their pediatrician immediately and take them in to have their blood glucose level checked right away,” Dr. Yousuf said. “A simple blood test will determine if diabetes is the cause.”

If diabetes is diagnosed, it’s important to follow the doctor’s instructions for monitoring the child’s blood sugar levels, taking the prescribed medications, eating a healthy diet and getting proper exercise.

While there is no cure for Type 1 diabetes, Type 2 accounts for the vast majority of diabetes cases and can sometimes be reversed through a good diet and exercise regimen.

January 7, 2022 —>

About Author: Luke Legner

Luke Legner is a writing coordinator at OSF HealthCare. He joined the Ministry in April 2021 after several years working in corporate communications in the heavy equipment industry. A Pontiac native, he graduated from Illinois State University in 2002 where he earned a bachelor’s degree in mass communication.

Luke and his wife, Ashley, reside in Bloomington and have one son and two daughters. When he’s not tackling a home improvement project, you can usually find Luke watching his beloved Chicago Cubs or The Andy Griffith Show.

View all posts by Luke Legner

Type 1 Diabetes in Children

Diabetes is a condition in which the body can’t make enough insulin, or can’t use insulin normally. Type 1 diabetes is an autoimmune disorder. The body’s immune system damages the cells in the pancreas that make insulin. Insulin is a hormone. It helps sugar (glucose) in the blood get into cells of the body to be used as fuel. When glucose can’t enter the cells, it builds up in the blood. This is called high blood sugar (hyperglycemia). High blood sugar can cause problems all over the body. It can damage blood vessels and nerves. It can harm the eyes, kidneys, and heart. It can also cause symptoms such as tiredness.

Type 1 diabetes is a long-term (chronic) condition. It may start at any age. Insulin from the pancreas must be replaced with insulin injections or an insulin pump.

There are two forms of type 1 diabetes:

• Immune-mediated diabetes. This is an autoimmune disorder in which the body’s immune system damages the cells in the pancreas that make insulin. This is the most common kind of type 1 diabetes.
• Idiopathic type 1. This refers to rare forms of the disease with no known cause.

What causes type 1 diabetes in a child?

The cause of type 1 diabetes is unknown. Researchers think some people inherit a gene than can cause type 1 diabetes if a trigger such as a virus occurs.

Which children are at risk for type 1 diabetes?

A child is more at risk for type 1 diabetes if he or she has any of these risk factors:

• A family member with the condition
• Caucasian race
• Being from Finland or Sardinia
• Is age 4 to 6, or 10 to 14

What are the symptoms of type 1 diabetes in a child?

Type 1 diabetes often appears suddenly. In children, type 1 diabetes symptoms may be like flu symptoms. Symptoms can occur a bit differently in each child. They can include:

• High levels of glucose in the blood and urine when tested
• Unusual thirst
• Dehydration
• Frequent urination (a baby may need more diaper changes, or a toilet-trained child may start wetting his or her pants)
• Extreme hunger but weight loss
• Loss of appetite in younger children
• Blurred vision
• Nausea and vomiting
• Belly (abdominal) pain
• Weakness and fatigue
• Irritability and mood changes
• Serious diaper rash that does get better with treatment
• Fruity breath and fast breathing
• Yeast infection in girls

The symptoms of type 1 diabetes can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is type 1 diabetes diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Your child may also have blood tests, such as:

• Fasting plasma glucose. The blood is tested after at least 8 hours of not eating.
• Random plasma glucose. The blood is tested when there are symptoms of increased thirst, urination, and hunger.

How is type 1 diabetes treated in a child?

Children with type 1 diabetes must have daily injections of insulin to keep the blood glucose level within normal ranges. Insulin is given either by injection or insulin pump. Your child’s healthcare provider will show you how to give your child insulin with either method.

Treatment will also include:

• Eating the right foods to manage blood glucose levels. This includes timing meals and counting carbohydrates.
• Exercise, to lower blood sugar
• Regular blood testing to check blood-glucose levels
• Regular urine testing to check ketone levels

What are the possible complications of type 1 diabetes in a child?

Type 1 diabetes can cause:

• Ketoacidosis. This is when blood sugar levels are very high and the body starts making ketones. This is a very serious condition that needs to be treated right away in the hospital, sometimes in the intensive care unit. If your child is not treated right away, they are at risk for diabetic coma. A child with a diabetic coma loses consciousness because of brain swelling. The brain swells because of the very high blood sugar levels.
• Low blood sugar (hypoglycemia). This is also sometimes called an insulin reaction. This occurs when blood glucose drops too low.

Your child’s healthcare provider will tell you how to avoid these problems.

Over time, high blood sugar levels can damage blood vessels. Balancing insulin, diet, and activity can help keep blood sugar levels in the target range and help prevent complications such as:

• Eye problems
• Kidney disease
• Nerve damage
• Tooth and gum problems
• Skin and foot problems
• Heart and blood vessel disease

How can I help my child live with type 1 diabetes?

A type 1 diabetes diagnosis can be stressful for a child and his or her family. A younger child may not understand all the life changes, such as glucose monitoring and insulin injections. A child may feel:

• As if he or she is being punished
• Guilty
• Fearful of death
• Angry toward the parent

Parents can help their child by treating him or her as a normal child with diabetes management as just one aspect of their daily life.

Many areas have diabetes camps, support groups, and other organizations for children with type 1 diabetes and their families. Talk with your child’s healthcare provider for more information.

When should I call my child’s healthcare provider?

Call your child’s healthcare team if you need help. Also call the healthcare team if your child:

• Has new symptoms
• Often has high blood glucose levels
• Often has hypoglycemia

Key points about type 1 diabetes in children

• Type 1 diabetes is a long-term (chronic) condition. It may start at any age. Only 5% of people with diabetes have type 1.
• Type 1 diabetes is a condition in which blood glucose levels are abnormally high.
• It is most frequently caused by an autoimmune disorder in which the body’s immune system destroys the cells in the pancreas that produce insulin.
• Children with type 1 diabetes must have daily injections of insulin to keep the blood glucose level within normal ranges.
• Without insulin, blood glucose levels continue to rise and death will occur.
• With the administration of insulin, and other management activities, children with type 1 diabetes can lead active, healthy lives.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Find a Doctor

• Endocrinology, Diabetes and Metabolism
• Diabetic Wound Care
• Diabetic Macular Edema

• Diabetes Mellitus
• Diabetes and Cardiovascular Diseases
• Diabetic Foot Care
• Diabetes
• Diabetes and Heart Research
• Diabetic Eye Related Issues

At Another Johns Hopkins Member Hospital:

• Howard County General Hospital
• Sibley Memorial Hospital
• Suburban Hospital

Find a Treatment Center

• Endocrinology, Diabetes and Metabolism

Find Additional Treatment Centers at:

• Howard County General Hospital
• Sibley Memorial Hospital
• Suburban Hospital