Test thyroid function
Test annually for thyroid function in patients with an elevated risk of thyroid dysfunction (eg, people with Down syndrome). Test also when changes in behaviour or adaptive functioning are detected.214, 215
Strongly Recommended
Empirical Expert
Endocrine disorders can be challenging to diagnose in people with IDD. They have a higher incidence of thyroid dysfunction compared with those in the general population.213
Establish thyroid function baseline
For patients taking lithium, atypical or second-generation antipsychotics, or seizure medications, establish a thyroid function baseline followed by an annual reassessment.216, 217
Strongly Recommended
Empirical Expert
Endocrine disorders can be challenging to diagnose in people with IDD. They have a higher incidence of thyroid dysfunction compared with those in the general population.213
Screen for diabetes early
Include patients with IDD among those at high risk of diabetes. Screen for type 2 diabetes at an earlier age than is recommended for the general population.218
Strongly Recommended
Ecosystem Experiential
The prevalence of diabetes is higher among people with IDD compared with those in the general population and slightly higher among women than men.218, 219
Provide diabetes education
Provide diabetes education to patients with IDD who have diabetes and their family and other caregivers that is adapted to people with IDD.220-222
Strongly Recommended
Expert Experiential
The prevalence of diabetes is higher among people with IDD compared with those in the general population and slightly higher among women than men.218, 219
213. Kapell D, Nightingale B, Rodriguez A, Lee JH, Zigman WB, Schupf N. Prevalence of chronic medical conditions in adults with mental retardation: Comparison with the general population. Ment Retard. 1998;36(4):269-79.
214. Beange H, Lennox N, Parmenter TR. Health targets for people with intellectual disability. Journal of Intellectual & Developmental Disability. 1999;24(4):283-97.
215. Cazeau R-A, Kamboj MK. Chapter 103: Endocrine issues. In: Rubin IL, Merrick J, Greydanus DE, Patel DR, editors. Health Care for People with Intellectual and Developmental Disabilities Across the Lifespan. Rubin and Crocker 3rd ed. Springer; 2016. p. 1257-79.
216. Bhaumik S, Branford D, Barrett M, Gangadharan SK, editors. The Frith Prescribing Guidelines for People with Intellectual Disability. 3rd ed. Chichester, West Sussex ; Hoboken, NJ: John Wiley & Sons Inc.; 2015.
217. Visser WE, de Rijke YB, van Toor H, Visser TJ. Thyroid status in a large cohort of patients with mental retardation: The TOP-R (thyroid origin of psychomotor retardation) study. Clin Endocrinol (Oxf). 2011;75(3):395-401.
218. Balogh RS, Lake JK, Lin E, Wilton A, Lunsky Y. Disparities in diabetes prevalence and preventable hospitalizations in people with intellectual and developmental disability: A population-based study. Diabet Med. 2015;32(2):235-42.
219. MacRae S, Brown M, Karatzias T, Taggart L, Truesdale-Kennedy M, Walley R, et al. Diabetes in people with intellectual disabilities: A systematic review of the literature. Res Dev Disabil. 2015;47:352-74.
220. Queensland Centre for Intellectual and Developmental Disability. Diabetes to the point [Website]. Brisbane, Australia: University of Queensland. 2016. Accessed 22 march 2017.
221. Taggart L., Truesdale-Kennedy M., Scott J. Working with people with people with intellectual and developmental disabilities who have diabetes. Journal of Diabetes Nursing. 2015;19(5):190-4.
222. Cardol M, Rijken M, van SL. People with mild to moderate intellectual disability talking about their diabetes and how they manage; 21955287. Journal of Intellectual Disability Research. 2012;56(4):351-60.
