Adults with developmental disabilities more likely to be diagnosed and hospitalized with diabetes: study

Adults in Ontario with intellectual and developmental disabilities (IDD) such as autism and Down syndrome are more likely to have diabetes than the general population and have a 2.6 times higher risk of being  hospitalized for diabetes-related conditions, according to new research.

“Our study shows that adults with IDD are at high risk for developing and being hospitalized for diabetes. Many of these hospitalizations could be prevented through primary care,” says Robert Balogh, lead author, assistant professor at the University of Ontario Institute of Technology, and adjunct scientist at ICES.

In the first study to compare prevalence and incidence rates of diabetes between adults with and without IDD, researchers at the Institute for Clinical Evaluative Sciences (ICES), University of Ontario Institute of Technology and the Centre for Addiction and Mental Health (CAMH), found a higher prevalence of diabetes among persons with IDD compared to the general population of Ontario without IDD (1.5 times higher prevalence in 2010).

“The results of our study clearly indicate that people with IDD experience a high level of diabetes and should be included as a high-risk group in clinical practice guidelines,” says Yona Lunsky, co-author of the study and an adjunct scientist at ICES and clinician scientist at CAMH.

The cohort study evaluated Ontarians with and without IDD between the ages of 30 and 69 until March 2010, and found:

• Sixteen per cent of people with IDD versus 9.7 per cent of people without IDD had diabetes.
• During a six year period, individuals with IDD had a consistently higher incidence and prevalence of diabetes compared to Ontarians without IDD.
• Females with IDD had a higher prevalence of diabetes (17.5 per cent) than males with IDD (15.3 per cent); the reverse of what is seen in the general population where diabetes is more common in males (11.9 per cent vs. females 9.6 per cent).

“This study highlights that not only do individuals with IDD have greater risk for a second complex chronic condition such as diabetes, but these other conditions appear to be inadequately addressed, resulting in more preventable hospitalizations. This paper is a call to action to healthcare professionals and health systems to correct gaps in care for patients with IDD,” said Dr. Shelia Laredo, Associate Professor in the Division of Endocrinology and Metabolism, Faculty of Medicine at the University of Toronto and Chief of Staff at Women's College Hospital.

The researchers suggest that people with IDD should be screened for Type 2 diabetes starting at 30-years-old, which is 10 years earlier than the recommendation currently in place for the general population.

“Among people with IDD, self-management can be a challenging task. It is necessary for clinicians and researchers to devise management programs targeted for this population that consider their unique cognitive and functional limitations,” adds Lunsky, also the director of the Healthcare Access Research and Developmental Disabilities (H-CARDD) program.

This research was primarily funded through CIHR's Partnerships for Health System Improvement (PHSI) program.

More information about the Healthcare Access Research and Developmental Disabilities program can be found at hcardd.ca

“Disparities in diabetes prevalence and preventable hospitalizations in persons with intellectual and developmental disability: a population study,” was published today in Diabetic Medicine.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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