UOIT researcher co-authors study on prevalence of diabetes among adults with developmental disabilities

A University of Ontario Institute of Technology (UOIT) faculty member has contributed to research looking at the prevalence and incidence of diabetes among adults with intellectual and developmental disabilities (IDD). The research also makes recommendations on how to address some of the health-care challenges of these adults.

The report, entitled Disparities in diabetes prevalence and preventable hospitalizations in persons with intellectual and developmental disability: A population study, found that adults with IDD, such as autism or Down syndrome, are more likely to have diabetes than the general population. They are also almost three times more likely to be hospitalized for diabetes-related conditions.

Dr. Robert Balogh, Assistant Professor, Faculty of Health Sciences, UOIT, and Adjunct Scientist at the Institute for Clinical Evaluative Sciences (ICES), was the lead author of the study. He noted that changes in the primary health care provided by community-based services, doctors and other health professionals could help address some of these issues.“Our study shows that adults with IDD are at high risk for developing and being hospitalized for diabetes, but that many of these hospitalizations are preventable through primary care,” he said.

The study, jointly conducted by researchers from UOIT, ICES and the Centre for Addiction and Mental Health, was the first to compare the prevalence and incidence rates of diabetes between adults with and without IDD. Using administrative health data from ICES, the researchers identified a group of Ontarians with and without IDD between the ages of 30 and 69. These individuals were compared to a random sample of individuals without IDD. For each sample, researchers looked at diabetes prevalence, incidence, age, sex, rurality, neighbourhood, income and morbidity. They also measured diabetes primary care by studying diabetes-related hospitalizations that were considered avoidable.

Researchers found that in 2010, the prevalence of diabetes among people with IDD was 1.5 times higher than what was found in the general Ontario population. Not only are individuals at greater risk for diabetes; they also experience the complications secondary to diabetes which appear to be inadequately addressed resulting in more preventable hospitalization.

Other findings:

• Sixteen per cent of people with IDD had diabetes, while 9.7 per cent of people without IDD had diabetes.
• During a six-year period, individuals with IDD had a consistently higher yearly 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). This is the reverse of what is seen in the general population where diabetes is more common in males (11.9 per cent) compared to females (9.6 per cent).
• Psychotropic medication (especially antipsychotic medications) can cause weight gain and secondary metabolic complications, which may influence the high prevalence of diabetes among people with IDD.

The researchers hope the paper will encourage health-care professionals and health systems to correct gaps in care for patients with IDD.

One of these gaps is related to the emphasis on self-management programs for chronic diseases in the general population. “It can be challenging for people with IDD to follow these programs,” Dr. Balogh noted. The report recommended devising management programs for them that take into consideration their unique cognitive and functional limitations.

Other recommendations:

• Include people with IDD as a high-risk group in clinical practice guidelines.
• Screen people with IDD for Type-2 diabetes starting at age 30, which is 10 years earlier than the recommendation currently in place for the general population
• Only prescribe psychotropic medications when clinically necessary – not simply for the treatment of routine problem behaviour.

This research was primarily funded through the Canadian Institutes of Health Research (CIHR) Partnerships for Health System Improvement (PHSI) program.

The study was published on October 3 in the journal Diabetic Medicine.

Related research:

Last year, Dr. Balogh also contributed to research that shines light on the challenges Ontario adults with IDD face when accessing health-care services.