Associations of symptoms of anxiety and depression with diabetes and cardiovascular risk factors in older people with intellectual disability

Winter, Channa de; Hermans, Heidi; Evenhuis, Heleen M.; Echteld, Michael A.

doi:10.1111/jir.12049

Cited by 27 publications

(27 citation statements)

References 39 publications

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“…The prevalence estimates ranged from 2% 84 to 13%. 90 The pooled prevalence of T2DM was 7.6%. The prevalence of any diabetes was 8.7%; this ranged from 2% 84 to 11% 95,102,117 (data not presented).…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

“…90 Combined evidence from other studies, as presented in the meta-analysis in Chapter 2, suggests a prevalence rate of 8% for T2DM in adults with ID. Data to enable comparison of rates for T2DM in the UK population with ID are scarce (it is suggested that 85-90% of diabetes is T2DM 20 ).…”

Section: Comparison With Previous Evidencementioning

confidence: 99%

“…After review, 62 articles 50,[81][82][83][84][85][86][87][88][89][90][93][94][95] were included. Four of these articles 90,[102][103][104] reported findings from the same study and a further two articles 109,125 reported findings from the same study, leaving 58 studies (see Table 3) remaining for the final systematic review and meta-analysis.…”

Section: Study Selectionmentioning

confidence: 99%

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Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited.ObjectivesThe objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD).SettingLeicestershire, UK.ParticipantsAdults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2and/or IGR were invited to take part in the education programme.Main outcome measuresThe primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed.Data sourcesParticipants were recruited from general practices, specialist ID services and clinics, and through direct contact.ResultsA total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals,n = 14; people with ID,n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity.LimitationsWe were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work.ConclusionsThe results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population.Future workFurther work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation.Trial registrationClinicalTrials.gov NCT02513277.FundingThe National Institute for Health Research Programme Grants for Applied Research programme and will be published in full inHealth Research Programme Grants for Applied Research; Vol. 5, No. 11. See the NIHR Journals Library website for further project information.

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Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

Section: Comparison With Previous Evidencementioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

See 1 more Smart Citation

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

View full text Add to dashboard Cite

show abstract

“…de Winter, Echteld, and Evenhuis (2014) studied chronic kidney disease, and found that overall rates were equal to the general population (i.e., 15.3%). They also reported that kidney disease was significantly associated with age, as well as with Down syndrome, obesity, hypercholesterolemia, and hypothyroidism.…”

Section: Ha-id In the Netherlandsmentioning

confidence: 98%

“…In their review, Haveman et al (2010) noted the complete lack of articles focused on co/multimorbidity, which is surprising given that co/multimorbidity is known to be high among adults with intellectual and developmental disabilities and to increase with age. Since then, discussions of comorbidity (e.g., mental health and Health Surveillance in Older Adults cardiovascular diseasedsee de Winter, Hermans, Evenhuis, & Echteld, 2015) and multimorbidity (see have appeared in the literature.…”

Section: Aging and Healthmentioning

confidence: 99%