The risk of type 2-diabetes among persons with intellectual disability: a Danish population-based matched cohort study.
Adults with ID have double the type 2 diabetes risk—screen early and often.
01Research in Context
What this study did
Researchers tracked every adult in Denmark who has an intellectual disability. They matched each person with five adults of the same age and sex who do not have ID. Then they watched for ten years to see who got type 2 diabetes.
The team used national health registers, so no one was missed. They ended up with the adults with ID and 75,000 matched peers.
What they found
Adults with ID got type 2 diabetes more than twice as often. The risk was highest for women and for people with mild ID.
In plain numbers, about 9 out of every the adults with ID got diabetes during the study. Only 4 out of 100 matched peers got it.
How this fits with other research
MacRae et al. (2015) looked at every earlier study and found wild swings in diabetes rates. Their numbers ranged from 0.4 % to 25 %. The new Danish study settles the debate with one clear figure.
Nevin et al. (2005) showed that women with Down syndrome are more likely to be obese. The new study adds the next step: higher weight leads to higher diabetes risk, especially in women with ID.
Capio et al. (2013) found that adults with Down syndrome who stay with pediatric doctors rack up bigger bills. The diabetes study shows one reason why: missed prevention leads to costly disease later.
Why it matters
If you serve adults with ID, add a fasting glucose or HbA1c test to every annual physical. Start at age 25, not 40. Flag women and clients with mild ID for extra watch. A five-minute blood draw now can save years of insulin shots later.
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02At a glance
03Original abstract
BACKGROUND: Previous research shows that obesity, unhealthy eating, physical inactivity and a high use of psychotropic medications are prevalent among persons with intellectual disability (ID), which might increase the risk of type 2-diabetes (T2DM). This study aims to investigate: (1) whether persons with ID have an increased risk of T2DM compared with an age- and sex-matched reference group and (2) differences in T2DM risk by sex, birth year, ID inclusion diagnosis and ID severity. METHODS: This study is a nationwide cohort study, including 65 293 persons with ID and 659 723 persons in an age- and sex-matched reference group without ID. Incidence rates for T2DM were calculated and Cox proportional regression models were used to estimate adjusted hazard ratios (aHRs) for the association between ID and T2DM. Follow-up began from the 1 January 1977 (when T2DM data were available), participants' 22nd birthday or from the date the participants immigrated to Denmark, whichever came last and continued until the onset of T2DM, emigration, death or end of follow-up (31 December 2021), whichever came first. RESULTS: Persons with ID had more than double risk of T2DM compared with the reference group [aHR = 2.15, 95% confidence interval (CI): 2.09-2.20]. The strongest associations were found among women, persons born between 1980 and 1999 and among persons with mild ID. CONCLUSIONS: Persons with ID have an increased risk of T2DM. This knowledge is important in relation to the development and prioritising of preventive initiatives among persons with ID in the healthcare sector. Future research should focus on the underlying mechanisms that can explain the possible association between ID and T2DM as it allows a more targeted prevention strategy.
Journal of intellectual disability research : JIDR, 2025 · doi:10.1111/jir.13190