Type 2 diabetes, once considered an adult disease, is now affecting children and teenagers at worrying rates.
Before the mid-1990s, only about 1% to 2% of young people with diabetes had type 2.
Today, that number has jumped to as high as 45%, with most diagnoses happening around age 13. Experts have long blamed rising childhood obesity, poor diet, and lack of exercise—but new research shows that where a child lives may also play a key role.
A new study from Florida Atlantic University’s Charles E. Schmidt College of Medicine examined how environmental and social factors might shape type 2 diabetes (T2D) risk in very young children.
Using national data from the U.S. National Survey of Children’s Health between 2016 and 2020, researchers focused on more than 174,000 children, including almost 50,000 under the age of 5—a group rarely studied in diabetes research.
The findings, published in Pediatric Research, suggest that a child’s surroundings may be just as important as personal habits in determining their risk.
Although the number of diabetes cases in children under five stayed low and steady over the five-year period, patterns began to emerge linking neighborhood environments with disease risk.
For example, children who lived in areas with more indoor-oriented amenities, such as libraries, were more likely to have a T2D diagnosis.
Researchers believe this connection may not be about libraries themselves but what they represent—urban environments that often lack walkable green spaces, playgrounds, or safe outdoor areas for physical activity.
“Neighborhood environments that limit opportunities for kids to move and play outdoors can increase their risk of chronic diseases like type 2 diabetes,” said Dr. Lea Sacca, the study’s senior author and assistant professor of population health at FAU.
Between 2016 and 2020, more caregivers also reported problems in their neighborhoods, such as litter, vandalism, and fewer safe places for children to play. These issues can discourage outdoor activity and contribute to sedentary lifestyles.
The study also found that families increasingly relied on food assistance programs like SNAP and free school meal plans during this time. While these programs help reduce hunger, they don’t always improve nutrition quality.
Many low-cost food options are highly processed and high in sugar or fat—factors that raise the risk of both obesity and diabetes.
“Access to food doesn’t always mean access to healthy food,” Sacca said. “Children in food-insecure households often have poorer blood sugar control and worse diet quality than those who don’t rely on assistance.”
The researchers emphasize that preventing diabetes in children will require more than promoting individual healthy choices—it will take community-wide changes.
Improving neighborhood design, expanding access to fresh foods, and creating safe spaces for physical activity could make a lasting difference.
Still, obesity remains the strongest predictor of type 2 diabetes. Overweight children are four times more likely to develop diabetes by age 25 than those with a healthy weight.
One of the biggest contributors is sugary drinks—nearly 70% of kids between ages 2 and 5 consume them daily. While some school policies have reduced access to sodas and sweetened beverages, overall consumption remains high.
Sacca said that broader efforts, such as banning sugary drinks in schools and raising beverage taxes, could help curb the problem.
“The rise in type 2 diabetes among young children is a growing public health concern,” she said. “To reverse this trend, we need to improve neighborhood conditions, ensure access to nutritious foods, and promote healthy habits from the very start of life.”
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