Disparities in diabetes prevalence and preventable hospitalizations in persons with intellectual and developmental disability: a population study

Aims — Adults with intellectual and developmental disabilities (IDD) are a vulnerable population with significant health issues and barriers to healthcare. Despite this, few studies have studied diabetes prevalence and incidence or how well the disease is managed among this population. The purpose of the current study, therefore, is to describe and compare population-level aspects of diabetes and diabetes primary care among persons with and without IDD.

Methods — Administrative health data accessed from the Institute for Clinical Evaluative Sciences was used to identify a cohort of Ontarians with and without IDD between the ages of 30 and 69 (N=28,567). These individuals were compared to a random sample of individuals without IDD (N=2,261,919) according to diabetes prevalence, incidence, age, sex, rurality, neighbourhood income, and morbidity. To measure diabetes primary care, we also studied hospitalizations for diabetes related ambulatory care sensitive (ACS) conditions.

Results — Adults with IDD had a consistently higher prevalence and incidence of diabetes compared to persons without IDD. Disparities in prevalence between those with and without IDD were most notable among females, younger adults, and those residing in rural or high income neighbourhoods. In terms of hospitalizations for diabetes related ACS conditions, individuals with IDD were 2.6 times more likely to be hospitalized.

Conclusions — Adults with IDD are at high-risk for developing and being hospitalized for diabetes. Findings of this study have a number of important implications related to the early detection, prevention, and proper management of diabetes among adults with IDD.