Intellectual Developmental Disability and All-Cause and Cause-Specific Mortality Among Individuals with Type 2 Diabetes Mellitus

Lee, Jun-Hyuk; Park, Yong-Moon; Han, Kyung Do; Park, Yebin; Jung, Jin-Hyung; Nam, Ga Eun

doi:10.2139/ssrn.5030195

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Intellectual Developmental Disability and All-Cause and Cause-Specific Mortality Among Individuals with Type 2 Diabetes Mellitus

23 Pages Posted: 25 Nov 2024

See all articles by Jun-Hyuk Lee

Jun-Hyuk Lee

Eulji University

Yong-Moon Park

University of Arkansas for Medical Sciences

Kyung Do Han

Soongsil University - Department of Statistics and Actuarial Science

Yebin Park

Soongsil University

Jin-Hyung Jung

Sungkyunkwan University School of Medicine

Ga Eun Nam

Korea University - College of Medicine

More...

Abstract

Background: Individuals with intellectual developmental disabilities (IDD) face unique challenges in managing type 2 diabetes mellitus (T2DM), but evidence on their impact on mortality is limited. This study assessed the association between IDD and mortality in T2DM using nationwide Korean data.

Methods: A retrospective cohort of 2,522,244 individuals with T2DM undergoing health screenings through the Korea National Health Insurance Service 2015–2016 was analyzed. IDD presence and severity were evaluated, and mortality risks were estimated using multivariable Cox proportional hazards models, adjusted for demographic, lifestyle, and clinical factors.

Findings: Participants had a mean age of 59·7 years (standard deviation: 12·0); 60·1% were men, and 0·22% (n = 5,627) had IDD. Over a six-year median follow-up, 201,153 deaths (7·98%) occurred. Individuals with IDD had a more than three-fold higher risk of all-cause mortality (HR 3·40, 95% CI: 3·14–3·68), with greater severity correlating with higher risk (P < 0·001). Cause-specific mortality risks were significantly elevated for cardiovascular (HR 3·77, 95% CI: 3·12–4·55), cancer (HR 1·52, 95% CI: 1·24–1·86), and respiratory diseases (HR 7·71, 95% CI: 6·27–9·48). Younger individuals showed stronger associations.

Interpretation: Individuals with T2DM and IDD, particularly those with severe IDD, have a significantly higher mortality risk. Tailored healthcare strategies and enhanced social support are urgently required to reduce disparities in this vulnerable population.

Funding: Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Korea University grant, and National Center for Advancing Translational Sciences.

Declaration of Interest: We declare no competing interests.

Ethical Approval: This study was reviewed and approved by the Institutional Review Board (IRB) of Korea University (IRB: SKKU2023-06-014).

Keywords: Intellectual Developmental Disability, Type 2 Diabetes Mellitus, Mortality, Cohort.

Suggested Citation: Suggested Citation

Lee, Jun-Hyuk and Park, Yong-Moon and Han, Kyung Do and Park, Yebin and Jung, Jin-Hyung and Nam, Ga Eun, Intellectual Developmental Disability and All-Cause and Cause-Specific Mortality Among Individuals with Type 2 Diabetes Mellitus. Available at SSRN: https://ssrn.com/abstract=5030195 or http://dx.doi.org/10.2139/ssrn.5030195