Risk of Diabetes Mellitus in Adults with Intellectual Disabilities: A Nationwide Cohort Study

Background Intellectual disability (ID) may be associated with an increased risk of diabetes mellitus (DM). However, evidence from longitudinal studies is scarce, particularly in Asian populations. Methods This retrospective cohort study used representative linked data from the Korea National Disabi...

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Main Authors: Hye Yeon Koo, In Young Cho, Yoo Jin Um, Yong-Moon Mark Park, Kyung Mee Kim, Chung Eun Lee, Kyungdo Han
Format: Article
Language:English
Published: Korean Endocrine Society 2025-02-01
Series:Endocrinology and Metabolism
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Online Access:http://e-enm.org/upload/pdf/enm-2024-2126.pdf
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author Hye Yeon Koo
In Young Cho
Yoo Jin Um
Yong-Moon Mark Park
Kyung Mee Kim
Chung Eun Lee
Kyungdo Han
author_facet Hye Yeon Koo
In Young Cho
Yoo Jin Um
Yong-Moon Mark Park
Kyung Mee Kim
Chung Eun Lee
Kyungdo Han
author_sort Hye Yeon Koo
collection DOAJ
description Background Intellectual disability (ID) may be associated with an increased risk of diabetes mellitus (DM). However, evidence from longitudinal studies is scarce, particularly in Asian populations. Methods This retrospective cohort study used representative linked data from the Korea National Disability Registration System and the National Health Insurance Service database. Adults (≥20 years) who received a national health examination in 2009 (3,385 individuals with ID and 3,463,604 individuals without ID) were included and followed until 2020. ID was identified using legal registration information. Incident DM was defined by prescription records with relevant diagnostic codes. Multivariable-adjusted Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for DM risks in individuals with ID compared to those without ID. Results Over a mean follow-up of 9.8 years, incident DM occurred in 302 (8.9%) individuals with ID and 299,156 (8.4%) individuals without ID. Having ID was associated with increased DM risk (aHR, 1.38; 95% CI, 1.23 to 1.55). Sensitivity analysis confirmed a higher DM risk in individuals with ID (aHR, 1.39; 95% CI, 1.24 to 1.56) than those with other disabilities (aHR, 1.11; 95% CI, 1.10 to 1.13) or no disability (reference). Stratified analysis showed higher DM risk in non-hypertensive subjects (aHR, 1.63; 95% CI, 1.43 to 1.86) compared to hypertensive subjects (aHR, 1.00; 95% CI, 0.80 to 1.26; P for interaction <0.001). Conclusion Adults with ID have an increased risk of developing DM, highlighting the need for targeted public health strategies to promote DM prevention in this population.
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spelling doaj-art-dabfc9200e8b4de181b812813bc991782025-08-20T03:04:26ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782025-02-0140110311110.3803/EnM.2024.21262555Risk of Diabetes Mellitus in Adults with Intellectual Disabilities: A Nationwide Cohort StudyHye Yeon Koo0In Young Cho1Yoo Jin Um2Yong-Moon Mark Park3Kyung Mee Kim4Chung Eun Lee5Kyungdo Han6 Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA Department of Social Welfare, Soongsil University, Seoul, Korea Department of Education, Sungshin Women’s University, Seoul, Korea Department of Statistics and Actuarial Science, Soongsil University, Seoul, KoreaBackground Intellectual disability (ID) may be associated with an increased risk of diabetes mellitus (DM). However, evidence from longitudinal studies is scarce, particularly in Asian populations. Methods This retrospective cohort study used representative linked data from the Korea National Disability Registration System and the National Health Insurance Service database. Adults (≥20 years) who received a national health examination in 2009 (3,385 individuals with ID and 3,463,604 individuals without ID) were included and followed until 2020. ID was identified using legal registration information. Incident DM was defined by prescription records with relevant diagnostic codes. Multivariable-adjusted Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for DM risks in individuals with ID compared to those without ID. Results Over a mean follow-up of 9.8 years, incident DM occurred in 302 (8.9%) individuals with ID and 299,156 (8.4%) individuals without ID. Having ID was associated with increased DM risk (aHR, 1.38; 95% CI, 1.23 to 1.55). Sensitivity analysis confirmed a higher DM risk in individuals with ID (aHR, 1.39; 95% CI, 1.24 to 1.56) than those with other disabilities (aHR, 1.11; 95% CI, 1.10 to 1.13) or no disability (reference). Stratified analysis showed higher DM risk in non-hypertensive subjects (aHR, 1.63; 95% CI, 1.43 to 1.86) compared to hypertensive subjects (aHR, 1.00; 95% CI, 0.80 to 1.26; P for interaction <0.001). Conclusion Adults with ID have an increased risk of developing DM, highlighting the need for targeted public health strategies to promote DM prevention in this population.http://e-enm.org/upload/pdf/enm-2024-2126.pdfintellectual disabilitydiabetes mellitusdisability studypublic health
spellingShingle Hye Yeon Koo
In Young Cho
Yoo Jin Um
Yong-Moon Mark Park
Kyung Mee Kim
Chung Eun Lee
Kyungdo Han
Risk of Diabetes Mellitus in Adults with Intellectual Disabilities: A Nationwide Cohort Study
Endocrinology and Metabolism
intellectual disability
diabetes mellitus
disability study
public health
title Risk of Diabetes Mellitus in Adults with Intellectual Disabilities: A Nationwide Cohort Study
title_full Risk of Diabetes Mellitus in Adults with Intellectual Disabilities: A Nationwide Cohort Study
title_fullStr Risk of Diabetes Mellitus in Adults with Intellectual Disabilities: A Nationwide Cohort Study
title_full_unstemmed Risk of Diabetes Mellitus in Adults with Intellectual Disabilities: A Nationwide Cohort Study
title_short Risk of Diabetes Mellitus in Adults with Intellectual Disabilities: A Nationwide Cohort Study
title_sort risk of diabetes mellitus in adults with intellectual disabilities a nationwide cohort study
topic intellectual disability
diabetes mellitus
disability study
public health
url http://e-enm.org/upload/pdf/enm-2024-2126.pdf
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