Diabetes mellitus

What is diabetes mellitus?

Diabetes mellitus (diabetes for short) is a condition in which the level of sugar (glucose) in the blood is too high. There are different forms of diabetes. The most common are type 1 diabetes (formerly known as 'childhood diabetes', 10% of cases) and type 2 (formerly known as 'adult-onset diabetes', 90% of cases). The leading major risk factors for type 2 diabetes are severe overweight, fat distribution around the waist, lack of physical activity and poor diet. Genetic predisposition also plays a role.

What are the complaints associated with diabetes mellitus?

People with increased glucose levels often do not notice. Some will have symptoms such as frequent urination, thirst, fatigue and weight loss. There may also be itching or skin abnormalities: wounds that heal poorly and skin infections. In time, diabetes may cause problems in the eyes, nerve tissue and blood vessels. That can result in poorer vision, pain and tingling in the arms and legs, problems with walking, sexual dysfunction, cardiovascular disease such as angina pectoris, heart attack or stroke.

People with intellectual disabilities sometimes find it impossible to communicate these symptoms. The people around them may then notice only a change in behaviour.

How common is diabetes in the general population?

It is known that 740,000 Dutch people (4.5% of the general population) have diabetes. The number of people with undiagnosed diabetes is at least 250,000. In total, therefore, there are about one million people with diabetes (6%) in the Netherlands. Nine out of ten people with diabetes have type 2 diabetes. The prevalence rate in children aged 1 to 14 years is approximately 0.3%, 4-9.1% in people aged 50-70 and approximately 15% in people aged 70 and over. The prevalence rate is 2 to 4 times higher in non-Western ethnic minorities (Turkish, Moroccan and Surinamese). ^{88 , 467}

How common is diabetes in people with intellectual disabilities?

A Dutch study of 470 people with intellectual disabilities aged 50 and older found a prevalence rate for diabetes of 8.7%. ⁸⁹

The prevalence rate for diabetes was 12.6% in the 611 participants in the Dutch GOUD study looking at older people (50+) with intellectual disabilities, which is not quite significantly higher than the prevalence rate in the general population. Diabetes was more common in people with milder intellectual disabilities who lived more independently and operated more independently in terms of daily activities such as groceries and cooking, older people and people with obesity. Diabetes was less common in people with Down syndrome. ⁴⁶⁸

The European POMONA questionnaire survey looked at a random sample of 1269 adults with intellectual disabilities and found that 4.3% had diabetes. ⁹⁰

A study of 290 people with intellectual disabilities in New York found that 4.5% had diabetes. ⁹⁰

Another US study of 5960 adults with intellectual disabilities found that 11.2% had diabetes. ⁹²

A large Australian questionnaire survey of 2540 people with intellectual disabilities (in which questionnaires were answered by carers and parents) found that 5% of the study sample had a history of diabetes. ⁹³