The risk of type 2-diabetes among persons with intellectual disability: a Danish population-based matched cohort study.
cohort study
epidemiology
intellectual disability
type 2‐diabetes
Journal
Journal of intellectual disability research : JIDR
ISSN: 1365-2788
Titre abrégé: J Intellect Disabil Res
Pays: England
ID NLM: 9206090
Informations de publication
Date de publication:
02 Oct 2024
02 Oct 2024
Historique:
revised:
02
09
2024
received:
21
06
2024
accepted:
11
09
2024
medline:
3
10
2024
pubmed:
3
10
2024
entrez:
3
10
2024
Statut:
aheadofprint
Résumé
Previous research shows that obesity, unhealthy eating, physical inactivity and a high use of psychotropic medications are prevalent among persons with intellectual disability (ID), which might increase the risk of type 2-diabetes (T2DM). This study aims to investigate: (1) whether persons with ID have an increased risk of T2DM compared with an age- and sex-matched reference group and (2) differences in T2DM risk by sex, birth year, ID inclusion diagnosis and ID severity. This study is a nationwide cohort study, including 65 293 persons with ID and 659 723 persons in an age- and sex-matched reference group without ID. Incidence rates for T2DM were calculated and Cox proportional regression models were used to estimate adjusted hazard ratios (aHRs) for the association between ID and T2DM. Follow-up began from the 1 January 1977 (when T2DM data were available), participants' 22nd birthday or from the date the participants immigrated to Denmark, whichever came last and continued until the onset of T2DM, emigration, death or end of follow-up (31 December 2021), whichever came first. Persons with ID had more than double risk of T2DM compared with the reference group [aHR = 2.15, 95% confidence interval (CI): 2.09-2.20]. The strongest associations were found among women, persons born between 1980 and 1999 and among persons with mild ID. Persons with ID have an increased risk of T2DM. This knowledge is important in relation to the development and prioritising of preventive initiatives among persons with ID in the healthcare sector. Future research should focus on the underlying mechanisms that can explain the possible association between ID and T2DM as it allows a more targeted prevention strategy.
Sections du résumé
BACKGROUND
BACKGROUND
Previous research shows that obesity, unhealthy eating, physical inactivity and a high use of psychotropic medications are prevalent among persons with intellectual disability (ID), which might increase the risk of type 2-diabetes (T2DM). This study aims to investigate: (1) whether persons with ID have an increased risk of T2DM compared with an age- and sex-matched reference group and (2) differences in T2DM risk by sex, birth year, ID inclusion diagnosis and ID severity.
METHODS
METHODS
This study is a nationwide cohort study, including 65 293 persons with ID and 659 723 persons in an age- and sex-matched reference group without ID. Incidence rates for T2DM were calculated and Cox proportional regression models were used to estimate adjusted hazard ratios (aHRs) for the association between ID and T2DM. Follow-up began from the 1 January 1977 (when T2DM data were available), participants' 22nd birthday or from the date the participants immigrated to Denmark, whichever came last and continued until the onset of T2DM, emigration, death or end of follow-up (31 December 2021), whichever came first.
RESULTS
RESULTS
Persons with ID had more than double risk of T2DM compared with the reference group [aHR = 2.15, 95% confidence interval (CI): 2.09-2.20]. The strongest associations were found among women, persons born between 1980 and 1999 and among persons with mild ID.
CONCLUSIONS
CONCLUSIONS
Persons with ID have an increased risk of T2DM. This knowledge is important in relation to the development and prioritising of preventive initiatives among persons with ID in the healthcare sector. Future research should focus on the underlying mechanisms that can explain the possible association between ID and T2DM as it allows a more targeted prevention strategy.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : National Institute of Public Health
Organisme : University of Southern Denmark
Organisme : Steno Diabetes Center Sjaelland
Informations de copyright
© 2024 The Author(s). Journal of Intellectual Disability Research published by MENCAP and John Wiley & Sons Ltd.
Références
Alborz A., McNally R. & Glendinning C. (2005) Access to health care for people with learning disabilities in the UK: mapping the issues and reviewing the evidence. Journal of Health Services Research & Policy 10, 173–182.
Ali A., Scior K., Ratti V., Strydom A., King M. & Hassiotis A. (2013) Discrimination and other barriers to accessing health care: perspectives of patients with mild and moderate intellectual disability and their carers. PLoS ONE 8, e70855.
Andersen J. S., Olivarius Nde F. & Krasnik A. (2011) The Danish National Health Service Register. Scandinavian Journal of Public Health 39, 34–37.
Anderson L. L., Larson S. A., MapelLentz S. & Hall‐Lande J. (2019) A systematic review of U.S. studies on the prevalence of intellectual or developmental disabilities since 2000. Intellectual and Developmental Disabilities 57, 421–438.
Axmon A., Ahlstrom G. & Hoglund P. (2017) Prevalence and treatment of diabetes mellitus and hypertension among older adults with intellectual disability in comparison with the general population. BMC Geriatrics 17, 272.
Bartlo P. & Klein P. J. (2011) Physical activity benefits and needs in adults with intellectual disabilities: systematic review of the literature. American Journal on Intellectual and Developmental Disabilities 116, 220–232.
Bishop R., Laugharne R., Shaw N., Russell A. M., Goodley D., Banerjee S. et al. (2024) The inclusion of adults with intellectual disabilities in health research—challenges, barriers and opportunities: a mixed‐method study among stakeholders in England. Journal of Intellectual Disability Research 68, 140–149.
Bourke J., de Klerk N., Smith T. & Leonard H. (2016) Population‐based prevalence of intellectual disability and autism spectrum disorders in western australia: a comparison with previous estimates. Medicine 95, e3737.
Carey I. M., Shah S. M., Hosking F. J., DeWilde S., Harris T., Beighton C. et al. (2016) Health characteristics and consultation patterns of people with intellectual disability: a cross‐sectional database study in English general practice. The British Journal of General Practice 66, e264–e270.
Carstensen B., Ronn P. F. & Jorgensen M. E. (2020) Prevalence, incidence and mortality of type 1 and type 2 diabetes in Denmark 1996–2016. BMJ Open Diabetes Research & Care 8, e001071.
Chalk T., Dunkley A., Gray L., Spong R., Gangadharan S., Davies M. et al. (2016) Rates of type 2 diabetes, cardiovascular disease and associated risk factors in people with intellectual disability populations: Systematic review and meta‐analysis. Diabetic Medicine 33, 73–74.
Cooper S. A., Melville C. & Morrison J. (2004) People with intellectual disabilities. BMJ 329, 414–415.
Cooper S. A., Smiley E., Morrison J., Williamson A. & Allan L. (2007) Mental ill‐health in adults with intellectual disabilities: prevalence and associated factors. The British Journal of Psychiatry 190, 27–35.
Costello A., Hudson E., Morrissey S., Sharma D., Kelly D. & Doody O. (2022) Management of psychotropic medications in adults with intellectual disability: a scoping review. Annals of Medicine 54, 2486–2499.
Cuypers M., Leijssen M., Bakker‐van Gijssel E. J., Pouls K. P. M., Mastebroek M. M., Naaldenberg J. et al. (2021) Patterns in the prevalence of diabetes and incidence of diabetic complications in people with and without an intellectual disability in Dutch primary care: insights from a population‐based data‐linkage study. Primary Care Diabetes 15, 372–377.
Dairo Y. M., Collett J., Dawes H. & Oskrochi G. R. (2016) Physical activity levels in adults with intellectual disabilities: a systematic review. Preventive Medical Reports 4, 209–219.
de Leon J., Greenlee B., Barber J., Sabaawi M. & Singh N. N. (2009) Practical guidelines for the use of new generation antipsychotic drugs (except clozapine) in adult individuals with intellectual disabilities. Research in Developmental Disabilities 30, 613–669.
Emerson E. & Baines S. (2011) Health inequalities and people with learning disabilities in the UK. Tizard Learning Disability Review. 16, 42–48.
Emerson E., Robertson J., Baines S. & Hatton C. (2016) Obesity in British children with and without intellectual disability: cohort study. BMC Public Health 16, 644.
Flygare Wallen E., Ljunggren G., Carlsson A. C., Pettersson D. & Wandell P. (2018) High prevalence of diabetes mellitus, hypertension and obesity among persons with a recorded diagnosis of intellectual disability or autism spectrum disorder. Journal of Intellectual Disability Research 62, 269–280.
Forbes J. M. & Fotheringham A. K. (2017) Vascular complications in diabetes: old messages, new thoughts. Diabetologia 60, 2129–2138.
Fredheim T., Haavet O. R., Danbolt L. J., Kjonsberg K. & Lien L. (2013) Intellectual disability and mental health problems: a qualitative study of general practitioners' views. BMJ Open 3, e002283.
Gregg E. W., Sattar N. & Ali M. K. (2016) The changing face of diabetes complications. The Lancet Diabetes and Endocrinology 4, 537–547.
Haveman M., Perry J., Salvador‐Carulla L., Walsh P. N., Kerr M., Van Schrojenstein Lantman‐de Valk H. et al. (2011) Ageing and health status in adults with intellectual disabilities: results of the European POMONA II study. Journal of Intellectual & Developmental Disability 36, 49–60.
Havercamp S. M. & Scott H. M. (2015) National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities. Disability and Health Journal 8, 165–172.
Helweg‐Larsen K. (2011) The Danish Register of Causes of Death. Scandinavian Journal of Public Health 39, 26–29.
Heslop P., Blair P. S., Fleming P., Hoghton M., Marriott A. & Russ L. (2014) The confidential inquiry into premature deaths of people with intellectual disabilities in the UK: a population‐based study. Lancet 383, 889–895.
Hoey E., Staines A., Walsh D., Corby D., Bowers K., Belton S. et al. (2017) An examination of the nutritional intake and anthropometric status of individuals with intellectual disabilities: results from the SOPHIE study. Journal of intellectual disabilities: JOID 21, 346–365.
Hove O. (2004) Weight survey on adult persons with mental retardation living in the community. Research in Developmental Disabilities 25, 9–17.
Hsieh K., Rimmer J. H. & Heller T. (2014) Obesity and associated factors in adults with intellectual disability. Journal of Intellectual Disability Research 58, 851–863.
Humphries K., Traci M. A. & Seekins T. (2009) Nutrition and adults with intellectual or developmental disabilities: systematic literature review results. Intellectual and Developmental Disabilities 47, 163–185.
Jorgensen M. E., Kristensen J. K., Reventlov Husted G., Cerqueira C. & Rossing P. (2016) The Danish Adult Diabetes Registry. Clinical Epidemiology 8, 429–434.
Kildemoes H. W., Sorensen H. T. & Hallas J. (2011) The Danish National Prescription Registry. Scandinavian Journal of Public Health 39, 38–41.
Lip G. Y. & Varughese G. I. (2005) Diabetes mellitus and atrial fibrillation: perspectives on epidemiological and pathophysiological links. International Journal of Cardiology 105, 319–321.
Lloyd M., Temple V. A. & Foley J. T. (2012) International BMI comparison of children and youth with intellectual disabilities participating in Special Olympics. Research in Developmental Disabilities 33, 1708–1714.
Lynge E., Sandegaard J. L. & Rebolj M. (2011) The Danish National Patient Register. Scandinavian Journal of Public Health 39, 30–33.
MacRae S., Brown M., Karatzias T., Taggart L., Truesdale‐Kennedy M., Walley R. et al. (2015) Diabetes in people with intellectual disabilities: a systematic review of the literature. Research in Developmental Disabilities 47, 352–374.
Maulik P. K., Mascarenhas M. N., Mathers C. D., Dua T. & Saxena S. (2011) Prevalence of intellectual disability: a meta‐analysis of population‐based studies. Research in Developmental Disabilities 32, 419–436.
McCarron M., Cleary E. & McCallion P. (2017) Health and health‐care utilization of the older population of ireland: comparing the intellectual disability population and the general population. Research on Aging 39, 693–718.
McGuire B. E., Daly P. & Smyth F. (2007) Lifestyle and health behaviours of adults with an intellectual disability. Journal of Intellectual Disability Research 51, 497–510.
McVilly K., McGillivray J., Curtis A., Lehmann J., Morrish L. & Speight J. (2014) Diabetes in people with an intellectual disability: a systematic review of prevalence, incidence and impact. Diabetic Medicine 31, 897–904.
Melville C. A., Finlayson J., Cooper S. A., Allan L., Robinson N., Burns E. et al. (2005) Enhancing primary health care services for adults with intellectual disabilities. Journal of Intellectual Disability Research 49, 190–198.
Melville C. A., Hamilton S., Hankey C. R., Miller S. & Boyle S. (2007) The prevalence and determinants of obesity in adults with intellectual disabilities. Obesity Reviews 8, 223–230.
Melville C. A., McGarty A., Harris L., Hughes‐McCormack L., Baltzer M., McArthur L. A. et al. (2018) A population‐based, cross‐sectional study of the prevalence and correlates of sedentary behaviour of adults with intellectual disabilities. Journal of Intellectual Disability Research 62, 60–71.
Messent P. R., Cooke C. B. & Long J. (1998) Daily physical activity in adults with mild and moderate learning disabilities: is there enough? Disability and Rehabilitation 20, 424–427.
Mors O., Perto G. P. & Mortensen P. B. (2011) The Danish Psychiatric Central Research Register. Scandinavian Journal of Public Health 39, 54–57.
Pedersen C. B. (2011) The Danish Civil Registration System. Scandinavian Journal of Public Health 39, 22–25.
Powrie E. (2003) Primary health care provision for adults with a learning disability. Journal of Advanced Nursing 42, 413–423.
Rimmer J. H. & Yamaki K. (2006) Obesity and intellectual disability. Mental Retardation and Developmental Disabilities Research Reviews 12, 22–27.
Robertson J., Emerson E., Gregory N., Hatto C., Turner S., Kessissoglou S. et al. (2000) Lifestyle related risk factors for poor health in residential settings for people with intellectual disabilities. Research in Developmental Disabilities 21, 469–486.
Schalock R. L., Luckasson R. & Tasse M. J. (2021) An overview of intellectual disability: definition, diagnosis, classification, and systems of supports (12th ed.). American Journal on Intellectual and Developmental Disabilities 126, 439–442.
Schmidt M., Schmidt S. A., Sandegaard J. L., Ehrenstein V., Pedersen L. & Sorensen H. T. (2015) The Danish National Patient Registry: a review of content, data quality, and research potential. Clinical Epidemiology 7, 449–490.
Smith E., Stogios N., Au E., Maksyutynska K., De R., Ji A. et al. (2022) The metabolic adverse effects of antipsychotic use in individuals with intellectual and/or developmental disability: a systematic review and meta‐analysis. Acta Psychiatrica Scandinavica 146, 201–214.
Spaul S. W., Hudson R., Harvey C., Macdonald H. & Perez J. (2020) Exclusion criterion: learning disability. Lancet 395, e29.
Straetmans J. M., van Schrojenstein Lantman‐de H. M., Schellevis F. G. & Dinant G. J. (2007) Health problems of people with intellectual disabilities: the impact for general practice. The British Journal of General Practice 57, 64–66.
Teeluckdharry S., Sharma S., O'Rourke E., Tharian P., Gondalekar A., Nainar F. et al. (2013) Monitoring metabolic side effects of atypical antipsychotics in people with an intellectual disability. Journal of intellectual disabilities: JOID 17, 223–235.
Thygesen L. C., Daasnes C., Thaulow I. & Brønnum‐Hansen H. (2011) Introduction to Danish (nationwide) registers on health and social issues: structure, access, legislation, and archiving. Scandinavian Journal of Public Health 39, 12–16.
Thygesen L. C., Lassen T. H., Horsbøl T. A., Mairey I. P., Juel K., Hoei‐Hansen C. E. et al. (2023) Mortality patterns in a Danish nationwide cohort of persons with intellectual disabilities. Journal of intellectual disabilities: JOID., 17446295231154102.
Tyrer F., Ling S., Bhaumik S., Gangadharan S. K., Khunti K., Gray L. J. et al. (2020) Diabetes in adults with intellectual disability: prevalence and associated demographic, lifestyle, independence and health factors. Journal of Intellectual Disability Research 64, 287–295.
Tyrer F., Morriss R., Kiani R., Gangadharan S. K., Kundaje H. & Rutherford M. J. (2024) Comparing the number and length of primary care consultations in people with and without intellectual disabilities and health needs: observational cohort study using electronic health records. Family Practice 41, 501–509.
Tyrer F., Smith L. K. & McGrother C. W. (2007) Mortality in adults with moderate to profound intellectual disability: a population‐based study. Journal of Intellectual Disability Research 51, 520–527.
Uldall P., Michelsen S. I., Topp M. & Madsen M. (2001) The Danish Cerebral Palsy Registry. A registry on a specific impairment. Danish Medical Bulletin 48, 161–163.
Vancampfort D., Schuch F., Van Damme T., Firth J., Suetani S., Stubbs B. et al. (2022) Prevalence of diabetes in people with intellectual disabilities and age‐ and gender‐matched controls: a meta‐analysis. Journal of Applied Research in Intellectual Disabilities 35, 301–311.
Williamson A., Allan L., Cooper S. A., Morrison J. & Curtice L. (2004) The general practitioner interface with people with intellectual disabilities and their supports. The European Journal of General Practice 10, 66–70.
World Health Organization. World report on disability. 2011.