This paper builds upon the limited existing literature on people with ID self-managing type 2 diabetes and provides a robust, qualitative account of the participants' experiences, whilst confirming some of the existing challenges, both for people with ID and their supporters. To self-manage with autonomy and overcome the difficulties of adjustment, further strategies such as training and education needs are highlighted. In addition, the meaning and relevance of the Self-efficacy construct is evaluated in the context of people with ID self-managing T2D. This provides useful information in terms of tailoring existing mainstream T2D interventions to meet the needs of people with ID, as such programs are commonly theoretically guided by Self-efficacy. Furthermore, this evaluation provides rationale for the exploration of people with IDs' Self-efficacy in relation to other chronic diseases, such as cardiovascular disease, cancer symptoms and gastrointestinal disorders.

Publisher rights Copyright © 2018 by SAGE Publications. This work is made available online in accordance with the publisher's policies. Please refer to any applicable terms of use of the publisher. General rightsCopyright for the publications made accessible via the Queen's University Belfast Research Portal is retained by the author(s) and / or other copyright owners and it is a condition of accessing these publications that users recognise and abide by the legal requirements associated with these rights. Methods Meta-aggregative methods were adopted to synthesise results, and an appraisal was reported of rigour.Result A total of eight studies met the inclusion criteria and four themes were extracted: i) "Frustration over lifestyle adjustments"; ii) "Limited understanding and inadequate educational resources"; iii) "Limited training and knowledge in staff"; iv) "Potential for effective DSM with appropriate support". ConclusionCurrent support is inadequate to meet the needs of people with ID and their caregivers self-managing diabetes. Structured education to improve health literacy and diabetes knowledge in people with ID is required, together with training for caregivers which leads to a culture of nurturing autonomy. BackgroundType 2 Diabetes (T2D) is a global epidemic associated with poor glycaemic control. There are complex and severe health risks associated with the disease, including renal failure, blindness, amputation due to circulatory problems, and cardiovascular risks such as stroke and myocardial infarction. There are therefore severe cost implications to health services from diabetes. Diabetes UK reported a cost of £23 billion in 2010/2011, of which 8.8 billion was for T2D (Hex et al., 2012). This figure is projected to almost double by 2035.The prevalence of T2D in people with intellectual disabilities (ID) compared to the mainstream population is unclear. The most recent review of diabetes prevalence rates in 3 people with ID was carried out by MacRae et al. (2015), who identified 22 studies. This provided a mean prevalence rate of 8.3%. This is compared to a global prevalence rate of 8.5% in the mainstream population (World Health Organisation, 2014). However, prevalence rates vary widely across studies, ranging from 0.4% to 25%, reflecting several reporting issues, such as failure to report differences in type of diabetes and a reliance on self-reports from people with ID, their family members or caregivers. Therefore, evidence suggests that prevalence rates may be higher for people with ID than for the general population.The lack of demographic information, such as living arrangements (absent in 15/24 of the studies in MacRae et al., 2015), is notable, as this may have elucidated for example whether people with ID who live in isolated situations are less likely to receive diabetes screening, hence not being screened for diabetes and receiving a diagnosis and treatment.This suggests that there is a lack of consistency over reporting details in studies about people with ID and diabetes. There i...

Background 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. 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. Results 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. Conclusions 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.

Background People with intellectual disabilities remain at high risk of developing type 2 diabetes (T2D) due to lifestyle‐associated risk factors. Educational programmes have been adapted for people with intellectual disabilities targeting ongoing T2D self‐management. However, there are no adapted programmes which aim to prevent T2D through reducing risk factors. The present study initiates addressing this gap. Methods Further education (FE) colleges in Scotland were recruited for feasibility study using the Walking Away (WA) from Diabetes programme. Process evaluation assessed recruitment, retention, baseline physical activity levels, and acceptability and accessibility using focus groups. Results Ninety six percent of invited students agreed to participate. WA was positively received, and some short‐term impact was described. Suggestions for further adaptations regarding materials, delivery and content were provided, including delivery embedded within FE college curriculum. Conclusions Recruitment, retention and acceptability provide rationale for further research on T2D prevention in FE colleges.