Prevalence of diabetes in adult patients with Down's syndrome living in a residential home.

Ohyama, Yoshio; Utsugi, T; Uchiyama, Toshimasa; Hanaoka, Tomoko; Tomono, Shoichi; Kurabayashi, M

doi:10.2337/diacare.23.5.705a

Cited by 8 publications

(9 citation statements)

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“…Of the six articles reviewed, one used a case–control design (II‐2) (Alexander et al 2016), two used a cohort (II‐2) (Real de Asua et al 2014a, 2014b), and three were case series (III) (Fulcher et al 1998; Ohyama et al 2000; Taggart et al 2013). In the case–control studies, the number of participants with DS ( N = 6,714) and healthy controls ( N = 19,276) were both large.…”

Section: Resultsmentioning

confidence: 99%

“…Subjects were ascertained from a longitudinal database (96%), outpatient clinic (1%), anonymous survey (1%), a residential living facility (1%), and a diabetes unit (1%). Two studies included laboratory evaluation (Real de Asua et al 2014a, 2014b); two were from a survey‐based dataset (Alexander et al 2016; Taggart et al 2013); and two involved retrospective chart review (Fulcher et al 1998; Ohyama et al 2000). We assigned interval validity ratings of good to three of the articles, fair to two and poor to one of the studies based upon design considerations.…”

Section: Resultsmentioning

confidence: 99%

“…One study reported an increased risk for developing diabetes in those with DS compared to the general population (Incidence risk ratio = 1.3) but oddly did not specify between type 1 and type 2 diabetes (Alexander et al 2016). Another study found no patients with DS in their cohort (N = 40) with confirmed T2DM (Ohyama et al 2000). Regarding comorbidities, the prevalence of diabetic retinopathy is reported in one very small study at one in nine (11%) (Fulcher et al 1998).…”

Section: Type 2 Diabetes Mellitusmentioning

confidence: 98%

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Co‐occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Part II

Capone

Chicoine

Bulova

et al. 2020

American J of Med Genetics Pt A

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Adults with Down syndrome (DS) represent a unique population who are in need of clinical guidelines to address their medical care. Many of these conditions are of public health importance with the potential to develop screening recommendations to improve clinical care for this population. Our workgroup previously identified and prioritized co-occurring medical conditions in adults with DS. In this study, we again performed detailed literature searches on an additional six medical conditions of clinical importance. A series of key questions (KQ) were formulated a priori to guide the literature search strategy. Our KQs focused on disease prevalence, severity, risk-factors, methodologies for screening/evaluation, impact on morbidity, and potential costs/benefits. The available evidence was extracted, evaluated and graded on quality. The number of participants and the design of clinical studies varied by condition and were often inadequate for answering most of the KQ. Based upon our review, we provide a summary of the findings on hip dysplasia, menopause, acquired cardiac valve disease, type 2 diabetes mellitus, hematologic disorders, and dysphagia. Minimal evidence demonstrates significant gaps in our clinical knowledge that compromises clinical decision-making and management of these medically complex individuals. The creation of evidence-based clinical guidance for this population will not be possible until these gaps are addressed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Type 2 Diabetes Mellitusmentioning

confidence: 98%

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Co‐occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Part II

Capone

Chicoine

Bulova

et al. 2020

American J of Med Genetics Pt A

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“…Not unlike other therapeutic considerations in medicine, the potential weight loss and metabolic benefits of bariatric or metabolic surgery must be weighed against potential risks or pitfalls on a case-by-case basis. Interestingly, obesity and its associated co-morbid conditions are prevalent in patients with cognitive impairment, but the risks and benefits of bariatric surgery in this complex group are not well known [1][2][3]. Studies examining outcomes have been limited to case reports, and thus most bariatric programs do not consider patients with intellectual and/or developmental disabilities to be surgical candidates [4].…”

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confidence: 99%

Bariatric surgery in the cognitively impaired

Daigle

Schauer

Heinberg

2015

Surgery for Obesity and Related Diseases

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“…1,2 Obesity and its related comorbidities are common among individuals with cognitive impairment, but the outcomes from bariatric surgery in this singular group remain uncertain. [3][4][5][6][7] The majority of bariatric programs exclude patients with intellectual and/or developmental disabilities, from surgical indication. Only 6.2% of programs have not considered severe levels of impairment,…”

Section: Introductionmentioning

confidence: 99%

Bariatric surgery in individuals with severe cognitive impairment: report of two cases

et al. 2018

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CONTEXT: Bariatric surgery has become the gold-standard treatment for refractory morbid obesity. Obesity is frequently associated with certain syndromes that include coexisting cognitive deficits. However, the outcomes from bariatric surgery in this group of individuals remain incompletely determined. CASE REPORT: A 25-year-old male with Prader-Willi syndrome, whose intelligence quotient (IQ) was 54, was admitted with a body mass index (BMI) of 55 kg/m 2 , associated with glucose intolerance. He underwent the Scopinaro procedure for biliopancreatic diversion, with uneventful postoperative evolution, and presented a 55% loss of excess weight one year after the surgery, with resolution of glucose intolerance, and without any manifestation of protein-calorie malnutrition. A 28-year-old male with Down syndrome, whose IQ was 68, was admitted with BMI of 41.5 kg/m 2 , associated with hypertension. He underwent Roux-en-Y gastric bypass, with uneventful postoperative evolution. He presented a 90% loss of excess weight one year after the surgery, with resolution of the hypertension. CONCLUSION: Bariatric surgery among individuals with intellectual impairment is a controversial topic. There is a tendency among these individuals to present significant weight loss and comorbidity control, but less than what is observed in the general obese population. The severity of the intellectual impairment may be taken into consideration in the decision-making process regarding the most appropriate surgical technique. Bariatric surgery is feasible and safe among these individuals, but further research is necessary to deepen these observations. RESUMOCONTEXTO: A cirurgia bariátrica tornou-se o tratamento padrão ouro para a obesidade mórbida refratária. A obesidade está frequentemente associada a certas síndromes nas quais também coexistem déficits cognitivos, entretanto, os resultados da cirurgia bariátrica nesse grupo de indivíduos ainda não foram completamente determinados. RELATO DE CASO: Um homem de 25 anos com síndrome de Prader-Willi, cujo quociente de inteligên-cia (QI) era estimado em 54, foi admitido com índice de massa corporal (IMC) de 55 kg/m 2 , associado com intolerância à glicose. Foi submetido a uma derivação biliopancreática à Scopinaro, com evolução pós-operatória sem complicações significativas. Apresentou perda de 55% do excesso de peso um ano após a cirurgia, com resolução da intolerância à glicose, sem manifestação de desnutrição proteico-calórica. Outro paciente, homem de 28 anos com syndrome de Down, cujo QI era de 68, foi admitido com IMC de 41,5 kg/m 2 , associado a hipertensão arterial. Foi submetido ao bypass gástrico em Y de Roux, com evolução pós-operatória sem complicações. Apresentou perda de 90% do excesso de peso após um ano e resolução da hipertensão. CONCLUSÃO: A cirurgia bariátrica em indivíduos com déficits intelectuais é um tópico controverso. Existe uma tendência entre esses indivíduos de apresentar perda de peso e controle de comorbidades significativos, porém menores que os observados na...

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Prevalence of diabetes in adult patients with Down's syndrome living in a residential home.

Cited by 8 publications

References 0 publications

Co‐occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Part II

Co‐occurring medical conditions in adults with Down syndrome: A systematic review toward the development of health care guidelines. Part II

Bariatric surgery in the cognitively impaired

Bariatric surgery in individuals with severe cognitive impairment: report of two cases

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