THE AUTHORS REPLY
Bullock and Sheff are correct that the trends in incidence among such youths that are reported in the study may not represent trends nationwide. We note that, for type 2 diabetes, although the point estimate for the increase in incidence among Native American youths was the highest observed (annual increase, 8.9%), this was significantly different only in the comparisons with non-Hispanic white youths and Hispanic youths. In the interest of improving capacity for representative surveillance of childhood diabetes among Native American youths, the SEARCH for Diabetes in Youth study is currently collaborating with the Indian Health Service (IHS) to identify accurate and cost-effective means to identify newly diagnosed cases of diabetes among IHS enrollees with the use of electronic health records.
Footnotes
Since publication of their article, the authors report no further potential conflict of interest.
Contributor Information
Elizabeth J. Mayer-Davis, University of North Carolina, Chapel Hill, NC
Dana Dabelea, Colorado School of Public Health Aurora, CO
Jean M. Lawrence, Kaiser Permanente Southern California Pasadena, CA