TY - JOUR
T1 - Quality of diabetes care among persons with intellectual disabilities and type 2 diabetes
T2 - A nationwide cohort study
AU - Thorsted, Anne
AU - Heltberg, Andreas
AU - Kofoed-Enevoldsen, Allan
AU - Michelsen, Susan Ishøy
AU - Andersen, Anette
AU - Østergaard, Liv Stubbe
AU - Lehn, Sara Fokdal
AU - Thygesen, Lau Caspar
N1 - Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2026/8
Y1 - 2026/8
N2 - AIMS: To investigate the quality of diabetes care among persons with intellectual disabilities (ID) and type 2 diabetes (T2DM).METHODS: A nationwide matched cohort study including 4219 persons with ID and T2DM and 16,863 age- and sex-matched persons with T2DM but without ID. Quality of care was assessed through national guideline indicators, including process measures (HbA1c, low-density lipoprotein cholesterol (LDL-C), urine albumin-creatinine ratio (UACR), foot screening) and result measures (HbA1c and LDL-C targets) from 2015 to 2021. Associations were analysed with mixed-effects logistic regression and reported as odds ratios with 95% confidence intervals.RESULTS: Compared with persons without ID, those with ID had higher odds of annual HbA1c assessment (OR=1.58, 95% CI 1.38-1.80) and foot screening (OR=2.14, 95% CI 1.86-2.47), but lower odds of UACR (OR=0.64, 95% CI 0.60-0.70). LDL-C assessments were similar. Achievement of HbA1c ≤ 7.0% (≤53 mmol/mol) was comparable (OR=1.01, 95% CI 0.90-1.14), whereas high HbA1c ≥ 8.6% (≥70 mmol/mol) was more frequent among persons with ID (OR=1.39, 95% CI 1.22-1.58). LDL-C ≤ 2.5 mmol/L was more common among persons with ID (OR=1.36, 95% CI 1.20-1.53).CONCLUSIONS: Persons with ID and T2DM have higher odds of poor glycaemic control despite increased monitoring, highlighting the need for improved management tailored to specific needs.
AB - AIMS: To investigate the quality of diabetes care among persons with intellectual disabilities (ID) and type 2 diabetes (T2DM).METHODS: A nationwide matched cohort study including 4219 persons with ID and T2DM and 16,863 age- and sex-matched persons with T2DM but without ID. Quality of care was assessed through national guideline indicators, including process measures (HbA1c, low-density lipoprotein cholesterol (LDL-C), urine albumin-creatinine ratio (UACR), foot screening) and result measures (HbA1c and LDL-C targets) from 2015 to 2021. Associations were analysed with mixed-effects logistic regression and reported as odds ratios with 95% confidence intervals.RESULTS: Compared with persons without ID, those with ID had higher odds of annual HbA1c assessment (OR=1.58, 95% CI 1.38-1.80) and foot screening (OR=2.14, 95% CI 1.86-2.47), but lower odds of UACR (OR=0.64, 95% CI 0.60-0.70). LDL-C assessments were similar. Achievement of HbA1c ≤ 7.0% (≤53 mmol/mol) was comparable (OR=1.01, 95% CI 0.90-1.14), whereas high HbA1c ≥ 8.6% (≥70 mmol/mol) was more frequent among persons with ID (OR=1.39, 95% CI 1.22-1.58). LDL-C ≤ 2.5 mmol/L was more common among persons with ID (OR=1.36, 95% CI 1.20-1.53).CONCLUSIONS: Persons with ID and T2DM have higher odds of poor glycaemic control despite increased monitoring, highlighting the need for improved management tailored to specific needs.
KW - Adult
KW - Aged
KW - Biomarkers/blood
KW - Blood Glucose/metabolism
KW - Diabetes Mellitus, Type 2/epidemiology
KW - Female
KW - Glycated Hemoglobin/metabolism
KW - Glycemic Control/standards
KW - Humans
KW - Intellectual Disability/epidemiology
KW - Male
KW - Middle Aged
KW - Quality Indicators, Health Care/standards
KW - Republic of Korea/epidemiology
KW - Risk Factors
U2 - 10.1016/j.pcd.2026.05.001
DO - 10.1016/j.pcd.2026.05.001
M3 - Article
C2 - 42128794
SN - 1751-9918
VL - 20
SP - 418
EP - 424
JO - Primary care diabetes
JF - Primary care diabetes
IS - 4
ER -