Abstract
Adults with intellectual disabilities (ID) may be at increased risk of developing type 2 diabetes and cardiovascular disease, due to lifestyle factors, medications and other diagnosed conditions. Currently, there is lack of evidence on prevalence and prevention in this population. The aim of this study was to conduct a diabetes screening programme to determine prevalence of previously undiagnosed type 2 diabetes and impaired glucose regulation in people with ID. Screening was conducted in a variety of community settings in Leicestershire, UK. Adults with ID were invited via: general practices; the Leicestershire Learning Disability Register; ID psychiatric services; and some people directly contacted the research team due to publicity about the study. Screening involved collection of anthropometric, biomedical and questionnaire data. Type 2 diabetes and impaired glucose regulation were defined according to (venous) fasting plasma glucose or HbA1c, following current World Health Organisation criteria. Nine hundred thirty adults (29% of those approached) participated. Mean age was 43years, 58% were male and 16% of South Asian ethnicity. Most participants were either overweight or obese (68%). Diabetes status was successfully assessed for 675 (73%) participants: Nine (1.3%, 95% confidence interval 0.6 to 2.5) were found to have undiagnosed type 2 diabetes, and 35 (5.2%, 95% confidence interval 3.6 to 7.1) had impaired glucose regulation. Key factors associated with abnormal glucose regulation included the following: non-white ethnicity and a first degree family history of diabetes. Results from this large multi-ethnic cohort suggest a low prevalence of screen-detected (previously undiagnosed) type 2 diabetes and impaired glucose regulation in adults with ID. However, the high levels of overweight and obesity we found emphasise the need for targeted lifestyle prevention strategies, which are specifically tailored for the needs of people with ID.
Highlights
People with intellectual disabilities (ID) continue to experience persistent health inequalities and higher rates of mortality compared with their non-disabled peers (Heslop et al 2014, Havercamp et al 2004), and experience barriers in accessing healthcare
In the general background population, increasing levels of obesity and sedentary lifestyles have been associated with a continued rise in non-communicable diseases, including type 2 diabetes and cardiovascular disease (World Health Organisation 2013)
Global prevalence estimates suggest around 9% of the adult population have diabetes, with type 2 diabetes accounting for the majority (~90%) of cases (International Diabetes Federation 2015, World Health Organisation 2016)
Summary
People with intellectual disabilities (ID) continue to experience persistent health inequalities and higher rates of mortality compared with their non-disabled peers (Heslop et al 2014, Havercamp et al 2004), and experience barriers in accessing healthcare. In the general background population, increasing levels of obesity and sedentary lifestyles have been associated with a continued rise in non-communicable diseases, including type 2 diabetes and cardiovascular disease (World Health Organisation 2013). A high proportion of people who have type 2 diabetes continue to remain undiagnosed (an estimated 39% in Europe, 47% worldwide) and are potentially at risk of developing associated health problems (International Diabetes Federation 2015). Identification of type 2 diabetes and intervention through screening has been shown to be a useful approach in the general adult population (Waugh et al 2007, Gillies et al 2008), given the increasing prevalence of type 2 diabetes and the conferred risk of developing cardiovascular disease. The value of screening for impaired glucose regulation (where blood glucose does not reach the threshold for diabetes but is raised above normal levels) has been demonstrated (Narayan and Gujral 2015)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
