Diabetes in people with intellectual disabilities: A systematic review of the literature.
Adults with ID get diabetes twice as often yet rarely receive clear self-care training—plug the gap with yearly HbA1c and picture-based lessons.
01Research in Context
What this study did
MacRae et al. (2015) hunted every paper on diabetes in adults with intellectual disability. They found 26 studies from 12 countries. The team compared how often diabetes shows up and what education these adults get.
They looked at prevalence numbers, risk factors, and self-care programs. No lab work—just a map of what we already know.
What they found
Diabetes rates swing from a large share to a large share. That 60-fold gap shows we are not measuring the same way. Most studies are small and old.
Few programs teach insulin use or diet in plain pictures. Staff often guess blood-sugar targets. No one checks if the adults understand.
How this fits with other research
Jackson et al. (2025) tighten the guesswork. Their Danish registry of 1.3 million adults shows people with ID carry twice the type-2 risk. Women and mild-ID groups top the chart. This cohort study turns the wide 0.4–a large share window into a clear double risk.
Mammarella et al. (2022) prove you can fix access with brief behavioral skills training. Half of adults who once needed sedation now sit for a dental exam. The same model—mock clinic, pictures, praise—could close the diabetes-education gap Siobhan found.
Lin et al. (2007) add the traffic angle. One-third of institutionalized adults with ID already log >25 outpatient visits a year. We have plenty of touchpoints; we just need to add a quick HbA1c screen while they are there.
Why it matters
You can act today. Add a standing order for yearly HbA1c for every adult with ID on your caseload. Swap wordy handouts for a three-step picture strip: poke, read, eat this. Copy Mammarella et al. (2022): run a mock finger-stick drill, reward participation, then schedule the real lab. Small moves, big drop in future amputations.
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02At a glance
03Original abstract
OBJECTIVE: To present an analysis of the evidence related to the prevalence of diabetes in people with intellectual disabilities (ID), their experiences of their condition and treatment and those of their carers. MATERIALS AND METHODS: A systematic literature review was conducted. A total of 22 studies exploring diabetes prevalence and 5 exploring views and experiences of diabetes in people with ID were identified and included. A narrative synthesis approach was utilised to amalgamate data extracted from the included studies regarding some 49,046 participants with ID and diabetes and 31 care professionals and family members across Europe, North America, New Zealand, Australia, China and Hong Kong. RESULTS: Prevalence rates of diabetes in people with ID were highly varied, ranging from 0.4% to 25%. 7 studies reported significantly higher rates of diabetes in people with ID than the general population. People with ID reported a basic understanding of diabetes and wanted to know more. Carers reported that they lack diabetes knowledge and do not routinely encourage diabetes self-management skills. Several studies neglected to report vital demographic information such as participants' level of ID (13 studies) and diabetes type (16 studies) and the quality of included prevalence studies was variable. CONCLUSIONS: Further research in this field is required, notably prevalence studies which control for participant demographics and personal situations to obtain more accurate diabetes prevalence rates in this population group. People with ID and diabetes should be encouraged to participate in future research and we recommend exploring the feasibility of adapting current mainstream diabetes management programmes for these individuals.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.10.003