Abstract
Risk reduction and self-management programs for type 2 diabetes (T2D) are commonplace. However, little is known about their appropriateness for people with intellectual disabilities (ID). This review evaluates successful components and theoretical basis of interventions and preventions in relation to the needs of people with ID with or at risk of T2D. Characteristics of 23 randomised controlled trialled T2D educational programs were systematically assessed alongside the needs of people with ID, and evaluated in terms of study design and theoretical application. Successful components of programs align to the needs of people with ID. Further adaptations are required to ensure accessibility of materials and social support to enable reflection on illness perceptions and self-efficacy, as underpinned by Self-regulation and Social-cognitive theories. Support is provided for further trials of self-management and preventative adaptations under development. Impact may be enhanced through preventions aimed at younger groups in educational settings.
Highlights
Diabetes is a global health concern, with 1.5 million deaths around the world attributed to the disease annually
Support is provided for further trials of self-management and preventative adaptations under development
Impact may be enhanced through preventions aimed at younger groups in educational settings
Summary
Diabetes is a global health concern, with 1.5 million deaths around the world attributed to the disease annually. Type 2 diabetes (T2D) is the instability of blood sugar levels due to the body’s low or ineffectively used insulin, and is associated with lifestyle factors, for example obesity, lack of physical activity, and medication control (Scottish Public Health Observatory, 2013). Self-management involves various lifestyle adaptations, including diet, exercise, monitoring of blood sugar levels, foot care, and adherence to medication regimes. Diabetes UK reported a cost of £23 billion in 2010/2011, of which 8.8 billion was for T2D (Hex, Bartlett, Wright, Taylor, and Varley, 2012). This figure is projected to almost double by 2035. Risk reduction and self-management programs for type 2 diabetes (T2D) are commonplace. Method: Characteristics of 23 randomised controlled trialled T2D educational programs were systematically assessed alongside the needs of people with ID, and evaluated in terms of study design and theoretical application
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