What is the clinical evidence from this study?

Study design: Observational. Population: Type 1 diabetes (n=26000000). Intervention: Type 1 diabetes incidence surveillance. Primary outcome: Incident type 1 diabetes.

What does this research mean for the field?

Between 2018 and 2023, the incidence of youth-onset Type 1 Diabetes in the U.S. was higher than prior estimates from 2002-2018, and incidence rates in young adults (aged 18-44) were similar in magnitude to those in youth. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to estimate the incidence of type 1 diabetes (T1D) in individuals aged under 45 years from 2018 to 2023 by age group, race/ethnicity, and sex.

June 7, 2026

2379-P: Incidence of Type 1 Diabetes in Persons Aged 45 Years in a Large U.S. Based Surveillance System in 2018–2023

Key Result

In a U.S. surveillance system from 2018-2023, type 1 diabetes incidence was 25.6-31.9 per 100,000 person-years in youth <18 years and 21.6-38.3 per 100,000 person-years in adults aged 18-44 years.

Key Points

This research aims to estimate the incidence of type 1 diabetes (T1D) in individuals aged under 45 years from 2018 to 2023 by age group, race/ethnicity, and sex.
Utilized the Diabetes in Children, Adolescents, and Young Adults (DiCAYA) Network across six health systems and two geographic sites.
Surveyed over 26 million individuals and identified incident T1D cases via electronic health records.
Calculated incidence rates by age, sex, race/ethnicity, and site type.
Identified 17,461 incident cases of T1D among youth under 18 years, with rates of 25.6 and 31.9 per 100,000 persons per year in health systems and geographic sites, respectively.
In adults aged 18-44 years, noted 28,310 cases with rates of 21.6 and 38.3 per 100,000 persons per year in health systems and geographic sites, respectively.
Observed higher incidence rates in males and significant variations by race/ethnicity, highest in non-Hispanic White and Black youth.

Study Design

Type

Observational (n=26,000,000)

Multicenter

Yes

Structured PICO

Population

Over 26 million individuals aged <45 years surveyed across six health systems and two geographic sites in the U.S. between 2018 and 2023.

Outcome

Incidence of type 1 diabetes (T1D) in 2018-2023

The incidence of type 1 diabetes in the U.S. from 2018-2023 is higher than prior estimates for youth, with young adult-onset rates similar in magnitude.

Abstract

Introduction and Objective: Incidence of type 1 diabetes (T1D) has been rising in U.S. children over the past two decades, while incidence patterns in young adults are less known. We estimated incidence of T1D in 2018-2023 among individuals aged 45 years by age group, race/ethnicity, and sex. Methods: The Diabetes in Children, Adolescents, and Young Adults (DiCAYA) Network includes six health system/networks (HS) and two population-level geographic sites, with 26 million individuals surveyed. Incident T1D was identified in electronic health records. Rates of new cases were calculated by age, sex, race/ethnicity and site type. Results: Between 2018 and 2023, 17,461 incident cases were identified among youth 18 years old. Incidence rates were 25.6 and 31.9 per 100,000 persons per year in HS and geographic sites, respectively, with variation by age, sex (in geographic sites) and race/ethnicity (Table). Rates were highest in non-Hispanic White and non-Hispanic Black, followed by Hispanic youth. In adults age 18-44 years, 28,310 cases occurred over the same period, with rates of 21.6 and 38.3 and per 100,000 persons per year in HS and geographic sites, respectively. Rates were higher in males and showed similar race/ethnicity patterns as youth. Conclusion: Youth-onset T1D incidence in 2018-2023 is higher than prior U.S. estimates from 2002-2018 and young adult-onset rates are similar in magnitude to youth-onset incidence. Disclosure T. Crume: None. A. Rajan: None. A. Bellatorre: None. R. Conway: None. M. Pavkov: None. I. Zaganjor: None. R. Anthopolos: None. J. Divers: None. S. Conderino: None. L. Thorpe: None. A.D. Liese: None. M. Mefford: Research Support; Current; Merck Ended; Merck Current; Sanofi. D. Dabelea: None. Funding Centers for Disease Control and Prevention (U18DP006521; U18DP006512; U18DP006509; U18DP006500; U18DP006513; U18DP006506; U18DP006693; U18DP006694; U18DP006517; U18DP006518; U18DP006633)

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