Type 2 diabetes and glucose intolerance in a population with intellectual disabilities: the STOP diabetes cross‐sectional screening study

Dunkley, Alison J.; Tyrer, Freya; Gray, Laura J.; Bhaumik, Sabyasachi; Spong, Rebecca; Chudasama, Yogini; Cooper, Sally‐Ann; Ganghadaran, Satheesh; Davies, Melanie J.; Khunti, Kamlesh

doi:10.1111/jir.12380

Cited by 15 publications

(17 citation statements)

References 31 publications

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“…Finally, our findings may reflect a lack of testing for diabetes in family households. Anecdotal evidence from our own screening study of T2DM in adults with ID (Dunkley et al 2017a) suggests that family carers could be reluctant to consent to a blood test, whereas such measurements were often routinely collected in residential settings. We recommend further research in this area.…”

Section: Discussionmentioning

confidence: 99%

“…A key limitation of our study was that our outcome measure and covariates were self-reported by carers/individuals with ID. Our study also relied on adults having been given a previous diagnosis; undiagnosed diabetes has been found to be relatively low in the study location but could only be determined on those who consented to be tested (Dunkley et al 2017a). It was also not possible to distinguish between type 1 diabetes mellitus, which is not lifestyle related, and T2DM.…”

Section: Limitationsmentioning

confidence: 99%

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Diabetes in adults with intellectual disability: prevalence and associated demographic, lifestyle, independence and health factors

Tyrer

Ling

Bhaumik

et al. 2020

J intellect Disabil Res

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Background As people with intellectual disabilities (ID) are now living longer, they are more at risk of developing non‐communicable diseases, including type 2 diabetes mellitus. However, understanding of factors associated with diabetes for targeted management and prevention strategies is limited. This study aimed to investigate prevalence of diabetes in adults (aged ≥18 years) with ID and its relationship with demographic, lifestyle, independence and health factors. Method This was a cross‐sectional analysis of interview data from 1091 adults with ID from the Leicestershire Learning Disability Register from 1 January 2010 to 31 December 2016. Logistic regression models were used to identify factors associated with diabetes in the study population. Results The study population did not have healthy lifestyles: just under half reported having lower physical activity levels than people without ID of a similar age; one‐quarter consumed fizzy drinks daily; and 20% consumed five or more fruit and/or vegetables per day. Prevalence of carer/self‐reported diabetes was 7.3% (95% confidence interval 5.9–9.0). After adjustment, diabetes was positively associated with South Asian ethnicity (P = 0.03) and older age groups (P < 0.001). Diabetes was less common in people living with family members (P = 0.02). We did not find a relationship between any of the lifestyle, independence and health factors investigated. Conclusions A significant proportion of people with ID are living with diabetes. Diabetes management and prevention strategies should be tailored to individuals' complex needs and include consideration of lifestyle choices. Such strategies may want to focus on adults of South Asian ethnicity and people living in residential homes where prevalence appears to be higher.

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Diabetes in adults with intellectual disability: prevalence and associated demographic, lifestyle, independence and health factors

Tyrer

Ling

Bhaumik

et al. 2020

J intellect Disabil Res

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“…; Dunkley et al . ) but, briefly, involved a population‐based screening programme of adults (aged 18–74 years) with ID in Leicestershire, UK. Participants were recruited between December 2012 and September 2015 from general practices and specialist ID services.…”

Section: Methodsmentioning

confidence: 99%

“…This study involved a cross-sectional analysis of the 'STOP Diabetes' cohort. The STOP Diabetes study, including full details of data collection, has been described elsewhere (Dunkley et al 2017a;Dunkley et al 2017b) but, briefly, involved a population-based screening programme of adults (aged 18-74 years) with ID in Leicestershire, UK. Participants were recruited between December 2012 and September 2015 from general practices and specialist ID services.…”

Section: Methodsmentioning

confidence: 99%

Multimorbidity and lifestyle factors among adults with intellectual disabilities: a cross‐sectional analysis of a UK cohort

Tyrer

Dunkley

Singh

et al. 2018

J intellect Disabil Res

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Background Multimorbidity [two or more conditions in addition to intellectual disability (ID)] is known to be more common among people with ID. However, the relationship between multimorbidity and lifestyle factors is currently unknown. The aim of this study was to determine the prevalence of multimorbidity in a population of adults with ID. We also aimed to identify risk factors, including lifestyle factors, for multimorbidity in this population. Methods This was a cross‐sectional analysis using data from a diabetes screening study of 920 adults aged 18–74 years with ID living in Leicestershire, UK. We described comorbidities and the prevalence of multimorbidity in this population. We explored the relationship between multimorbidity and age, gender, ethnicity, severity of ID, socio‐economic status, physical activity, sedentary behaviour, fruit and vegetable consumption and smoking status using multiple logistic regression. Results The prevalence of multimorbidity was 61.2% (95% CI 57.7–64.7). Multimorbidity was independently associated with being female (P < 0.001) and severe/profound ID (P = 0.004). Increasing age was of borderline significance (P = 0.06). Individuals who were physically inactive or sedentary were more likely to be multimorbid, independent of ability to walk, age, gender, severity of ID, ethnicity and socio‐economic status (adjusted OR = 1.91; 95% CI 1.23–2.97; P = 0.004 and OR = 1.98; 95% CI 1.42–2.77; P < 0.001). After excluding probable life‐long conditions (autism spectrum conditions, attention deficit hyperactivity disorders, epilepsy, cerebral palsy and other paralytic syndromes) as contributing comorbidities, the effect of sedentary behaviour, but not physical activity, remained (P = 0.004). We did not observe a relationship between multimorbidity, fruit and vegetable consumption and smoking status. Conclusions Multimorbidity presents a significant burden to people with ID. Individuals who were physically inactive or sedentary were more likely to be multimorbid, but further work is recommended to explore the relationship between multimorbidity and lifestyle factors using standardised objective measures.

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“…The ‘STOP Diabetes’ program was developed as a multi-component lifestyle behaviour change initiative for the prevention of T2D targeting cardiovascular risk factors in adults with IDD [ 23 – 25 ]. A multi-disciplinary team were brought together comprising expertise in the field of IDD and in mainstream diabetes.…”

Section: Stop Diabetes Prevention Programmentioning

confidence: 99%

Health Promotion and Wellness Initiatives Targeting Chronic Disease Prevention and Management for Adults with Intellectual and Developmental Disabilities: Recent Advancements in Type 2 Diabetes

Taggart¹,

Truesdale

Dunkley

et al. 2018

Curr Dev Disord Rep

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Purpose of ReviewThe aim of this paper was to review the recent international developments in health promotion and wellness initiatives targeting chronic disease prevention and management for adults with intellectual and developmental disabilities (IDD) targeting type 2 diabetes (T2D).Recent FindingsThere has been one diabetes prevention program (STOP) and two self-management T2D education programs (DESMOND-ID; OK diabetes) adapted for this population. All three programs have been adapted from other theoretically informed and tested programs developed for the general population. Each program has employed co-design and co-production techniques with all stakeholders. The three programs all target the high-risk lifestyle factors that can lead to T2D and contribute to poor glycaemia control, and have undertaken randomized-feasibility studies, the results of which are promising.SummaryThis paper shows that any health promotion and wellness initiatives need to be tailored and reasonable adjustments made in order to address this population’s cognitive impairments and communication difficulties.

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Type 2 diabetes and glucose intolerance in a population with intellectual disabilities: the STOP diabetes cross‐sectional screening study

Cited by 15 publications

References 31 publications

Diabetes in adults with intellectual disability: prevalence and associated demographic, lifestyle, independence and health factors

Diabetes in adults with intellectual disability: prevalence and associated demographic, lifestyle, independence and health factors

Multimorbidity and lifestyle factors among adults with intellectual disabilities: a cross‐sectional analysis of a UK cohort

Health Promotion and Wellness Initiatives Targeting Chronic Disease Prevention and Management for Adults with Intellectual and Developmental Disabilities: Recent Advancements in Type 2 Diabetes

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