High prevalence of diabetes mellitus, hypertension and
obesity among persons with a recorded diagnosis of
intellectual disability or autism spectrum disorder
E. Flygare Wallén,
A. C. Carlsson,
& P. Wändell
Academic Primary Health Care Centre, Stockholm County Council, Stockholm, Sweden
Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet,
Public Health Care Services Committee Administration, Stockholm County Council, Stockholm, Sweden
Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
Background Obesity and lack of physical activity are
frequently reported in persons with intellectual
disability (ID) or autism spectrum disorder (ASD).
We hypothesised a higher prevalence of diabetes and
hypertension in this population.
Method We used administrative data for all primary
and specialist outpatient and inpatient healthcare
consultations for people with at least one recorded
diagnosis of diabetes mellitus, hypertension or obesity
from 1998 to 2015. Data were drawn from the central
administrative database for Stockholm County,
Sweden. It was not possible to separate data for type 1
and type 2 diabetes. We stratiﬁed 26 988 individuals
with IDs or ASD into three groups, with Down
syndrome treated separately, and compared these
groups with 1 996 140 people from the general
Results Compared with the general population, men
and women with ID/ASD had 1.6–3.4-fold higher
age-adjusted odds of having a registered diagnosis of
obesity or diabetes mellitus, with the exception of
diabetes among men with Down syndrome. A
registered diagnosis of hypertension was only more
common among men with ID/ASD than in the
Conclusions Diabetes and blood pressure health
screening, along with efforts to prevent development
of obesity already in childhood, are necessary for
individuals with IDs and ASD. We believe that there
is a need for adapted community-based health pro-
motion programmes to ensure more equitable health
for these populations.
Keywords autism spectrum disorder, diabetes
mellitus, down syndrome, hypertension, intellectual
disability, prevalence studies
Diabetes mellitus and obesity are two-to-three times
more prevalent in individuals with ID or autism
spectrum disorder (ASD).
Primary health care needs to screen for pre-diabetes
and hypertension in individuals with ID or ASD.
Primary health care needs to pay early attention to
weight gain and initiate prevention strategies to
hinder obesity and its consequences.
Correspondence: Eva Flygare Wallén, PhD Academic Primary
Health Care Centre, Stockholm County Council, Solnavägen 1e, 113
65 Stockholm, Sweden, Phone: +46-763-470804 (e-mail: eva.ﬂygare.
Journal of Intellectual Disability Research doi: 10.1111/jir.12462
4 pp 269–280 A
© 2017 MENCAP and International Association of the Scientiﬁc Study of Intellectual and Developmental Disabilities and
John Wiley & Sons Ltd