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Study Finds Children, Young Adults with Down Syndrome More Likely to Develop Diabetes

An analysis of data from more than 9900 people with Down syndrome and 38,000 controls provides new insight into the apparent increase in risk of developing diabetes among children and young adults with Down syndrome.

A new study from investigators at Queen Mary University of London and King’s College London suggests children and young adults with Down syndrome were 3.6 times more likely to be diagnosed with diabetes than their counterparts without Down syndrome.

A retrospective cohort analysis matching children and young adults with Down syndrome in a 1:4 ratio to those without Down syndrome from the UK Clinical Practice Research Datalink, results of the study found that the overall risk of developing diabetes for individuals aged 5-24 years was 3.6 times greater among those with Down syndrome than their counterparts without Down syndrome, with investigators noting the risk among children aged 5-14 years with Down syndrome was 10 times greater than that of their counterparts without Down syndrome.

“This is the largest study ever conducted in Down Syndrome patients to show that they have unique needs with regards to diabetes and obesity, and that screening and intervention- including a healthy diet and physical activity - at younger ages is required compared to the general population,” said study investigator Andre Strydom, MSc, PhD, a professor in intellectual disabilities at King’s College London, in a statement. “The results will help to inform the work of National Health Service England’s LeDeR programme to reduce inequalities and premature mortality in people with Down Syndrome and learning disabilities.”

Citing a lack of conclusive research into the potential links between genetic factors in Down syndrome and risk of developing diabetes, investigators designed the current study to estimate potential associations with Down syndrome and incidence of diabetes as well as the relationship with obesity across the life span of these individuals compared with control subjects. With this in mind, investigator set out to conduct a matched population-based cohort study using data obtained from the UK Clinical Practice Research Datalink database from 1990-2020. From the database, investigators obtained data related to 9917 people with Down syndrome and 38,266 controls without Down syndrome for inclusion in their analyses.

Upon analysis, results indicated the rate of incident diabetes was greater among people with Down syndrome (iRR, 3.67 [95% CI, 2.43-5.55]; P <.0001) and peaked at a younger age (median age at diagnosis: 38 [IQR, 28-49] years vs 53 [IQR, 43-61] years) than among those without Down syndrome. When assessing risk for type 1 diabetes specifically, results indicated incidence rates per 1000 person-years were 0.44 (95% CI, 0.31-0.61) and 0.13 (95% CI, 0.09-0.17) among those with Down syndrome and without Down syndrome, respectively.

When assessing risk for type 2 diabetes, results suggested rates were greater among those with Down syndrome compared to control patients across age groups ranging from 5 years old up to 34 years old. Investigators also pointed out the peak mean BMI was greater and occurred at younger age for patients with Down syndrome (males: 31.2 kg/m2 at age 31 years; females: 32.1 kg/m2 at 43 years) compared to control patients (males 29.5 kg/m2 at 54 years; females 29.2 kg/m2 at 51 years).

“Currently there is a sizeable gap in research into the condition, which affects around 40,000 people in the UK. To help plug this gap in knowledge, we are conducting further research into how genetics affects a person with Down Syndrome’s predisposition to diabetes and obesity, and hope to shed further light on this important medical issue,” said senior investigator Li Chan, PhD, reader in molecular endocrinology and metabolism and a consultant pediatric endocrinologist at Queen Mary University of London, in the aforementioned statement.

This study, “Diabetes and Obesity in Down Syndrome Across the Lifespan: A Retrospective Cohort Study Using U.K. Electronic Health Records,” was published in Diabetes Care.