1.
Neonatal hyperglycaemia is associated with worse neurodevelopmental outcomes in extremely preterm infants.
Zamir, I, Stoltz Sjöström, E, Ahlsson, F, Hansen-Pupp, I, Serenius, F, Domellöf, M
Archives of disease in childhood. Fetal and neonatal edition. 2021;(5):460-466
-
-
Free full text
-
Abstract
OBJECTIVE To assess the associations between neonatal hyperglycaemia and insulin treatment, versus long-term neurodevelopmental outcomes in children born extremely preterm. DESIGN AND SETTING Observational national cohort study (Extremely Preterm Infants in Sweden Study) using prospectively and retrospectively collected data. Neurodevelopmental assessment was performed at 6.5 years of age. PATIENTS 533 infants born <27 gestational weeks during 2004-2007; 436 survivors were assessed at 6.5 years. OUTCOME MEASURES Neurodevelopmental disability (NDD), survival without moderate to severe NDD, Wechsler Intelligence Scale for Children IV Full scale intelligence quotient (WISC-IV FSIQ) and Movement Assessment Battery for Children 2 (MABC-2) total score. RESULTS Duration of neonatal hyperglycaemia >8 mmol/L was associated with WISC-IV scores-for each day with hyperglycaemia there was a decrease of 0.33 points (95% CI 0.03 to 0.62) in FSIQ. Neonatal hyperglycaemia >8 mmol/L occurring on 3 consecutive days was associated with lower MABC-2 scores (adjusted mean difference: -4.90; 95% CI -8.90 to -0.89). For each day with hyperglycaemia >8 mmol/L, there was a decrease of 0.55 points (95% CI 0.17 to 0.93) in MABC-2 total score. Insulin treatment was not associated with any of the outcome measures. CONCLUSION Neonatal hyperglycaemia >8 mmol/L was associated with lower intelligence scores and worse motor outcomes at 6.5 years of age. Insulin treatment was not associated with either worsened or improved neurodevelopmental outcomes. Randomised controlled trials are needed to clarify the role of insulin in treating hyperglycaemia in extremely preterm infants.
2.
Medication and supplement use in older people with and without intellectual disability: An observational, cross-sectional study.
Peklar, J, Kos, M, O'Dwyer, M, McCarron, M, McCallion, P, Kenny, RA, Henman, MC
PloS one. 2017;(9):e0184390
Abstract
INTRODUCTION Understanding the medication and supplement use of aging people is critical to ensuring that health service providers in primary care can optimise use of these agents. An increasing number of people with different levels of intellectual disability (ID) are living in the community and becoming for the first time substantial users of primary health care services. This, however, brings new challenges that need to be addressed at the primary health care level. We quantified the use of medicines and food supplements and described the associated patterns of morbidity in the two comparable cohorts of aging population with and without intellectual disability. METHOD This research aligned participants of 50 years and over who lived in the community from two nationally representative cohorts of older people; those with ID from the Intellectual Disability Supplement (n = 238) and those without ID (n = 8,081) from the Irish Longitudinal Study on Ageing. RESULTS Data showed that both medication and supplement use in the two groups was prevalent but that those with ID received more of both medications and supplements (e.g. polypharmacy was 39.0% in ID vs. 18.1% in non-ID cohort). Moreover, based on an analysis of the therapeutic groups and medications used that treatment was more intense in the ID cohort (95.8 vs. 7.0 International Non-proprietary Names per 100 participants). Supplement use was almost twice as prevalent in the ID group but substantially less diverse with only 10 types of supplements reported. Morbidity was higher in the ID group and showed a higher prevalence of neurological and mental health disorders. CONCLUSION The results highlight that the burden of therapy management and the potential risks in those ageing with ID differs substantially from those ageing without ID. Understanding the medication and supplement use of people aging with intellectual disability (ID) is critical to ensuring that health service providers in primary/ambulatory care can optimise use of these agents.
3.
The prevalence and risk factors of the metabolic syndrome in inpatients with intellectual disability.
Room, B, Timmermans, O, Roodbol, P
Journal of intellectual disability research : JIDR. 2016;(6):594-605
Abstract
BACKGROUND The aim of this study is to explore the prevalence and influencing factors of metabolic syndrome (MetS) in people with intellectual disabilities (IDs) and behavioural problems in a Dutch special healthcare institution. METHODS This observational study was conducted from medical records of physical examinations, laboratory results, medication (history), ethnicity and length of stay, as well as from questionnaires about lifestyle and smoking habits. MetS was defined by using the criteria of the 2009 consensus guidelines. The questions in this study were about the prevalence of MetS over a 1-year period and exploration of the differences between the people with and without MetS to determine the factors associated with it. RESULTS The overall prevalence of MetS in the selected population of people with IDs and behavioural problems was 46%. The factors 'use of conventional antipsychotics', 'age', and a ' low nutrition score' increased the risk of developing MetS. Together, these variables determine 19% of the variance in the incidence of MetS. CONCLUSIONS The study indicates a firm prevalence of MetS in a vulnerable population, whereby a minority of contributing factors was determined. Professionals should be particularly alert during the provision of antipsychotics, diet and exercise habits to prevent MetS when treating people with IDs and behavioural problems, and further studies are needed to explore the factors that contribute to the nascence and prevalence of MetS.
4.
Influence of sleep timing behavior on weight status and activity patterns in adults with intellectual disabilities.
Mikulovic, J, Dieu, O, Fardy, PS, Bui-Xuan, G, Vanhelst, J
Research in developmental disabilities. 2014;(12):3254-9
Abstract
The aim was to explore the relationship between sleep habits and overweight/obesity, physical activity and sedentary behaviors in French adults with intellectual disabilities. This observational study was conducted on 570 French adults with intellectual deficiency. Sleep habits were analyzed and related to anthropometric measures, physical activity and sedentary behaviors. The study was conducted using a self-administered questionnaire. Participants completed the questionnaire during an interview with the principal investigator. Sleep timing behavior was classified into 4 sleep patterns: Early-bed/Early-rise, Early-bed/Late-rise, Late-bed/Late-rise, and Late-bed/Early-rise. Of 570 eligible participants, 61 were excluded because of missing data on age, weight or height. The number of participants identified in each of the four sleep patterns was as follows: Early-bed/Early-rise, N = 119 (23%), Early-bed/Late-rise, N = 171 (34%), Late-bed/Early-rise, N = 100 (20%), Late-bed/Late-rise N = 119 (23%). Participants who wake up earlier are more active than those who rise late (p < 0.02). Participants who slept later spent more time in sedentary activities than those in the Early rise groups (p < 0.01). The number of obese/overweight participants was also higher in Late-bed/Late rise group. Sleep behavior was associated with overweight/obesity, physical activity and sedentary behavior in adults with intellectual deficiency, independently the sleep duration. Implementing intervention or promotion programs on sleep behaviors should be considered in order to meet the objectives of promoting health on anthropometric characteristics and increased physical activity among these disabled adults.