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.
Thorsted et al. (Fri,) studied this question.