Endocrinol Metab.  2025 Feb;40(1):103-111. 10.3803/EnM.2024.2126.

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

• Koo HY
• Cho IY
• Um YJ
• Park YMM
• Kim KM
• Lee CE
• Han K

• KMID: 2565258
• DOI: http://doi.org/10.3803/EnM.2024.2126

Abstract

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.

Keyword

Intellectual disability; Diabetes mellitus; Disability study; Public health

Figure

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  Fig. 1. Cumulative Kaplan-Meier incidence probability of diabetes mellitus according to intellectual disability (ID)a. aAdjusted for sex, age, income level, smoking, drinking, regular exercise, body mass index, hypertension, dyslipidemia, chronic kidney disease, and depression.

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