To the Editor The SEARCH investigators assessed the burden of diagnosed diabetes among youth.1 We wish to discuss 2 important limitations of the SEARCH study design.
First, the SEARCH study design cannot account for undiagnosed type 2 diabetes and therefore underestimates disease burden. The authors acknowledged this limitation but speculated that the number of cases was small based on only 2 specific citations: the first citation was from a geographically homogenous sample and the second was from a sample of sixth graders, thus underestimating the rates among older adolescents.
Demmer RT, Zuk AM, Rosenbaum M. Diabetes Prevalence Among Youth. JAMA. 2014;312(11):1153. doi:10.1001/jama.2014.9617