Endocrine Abstracts

Background: Between 1–2% of the population have an intellectual disability (ID), within this group the rate of diabetes is approximately 12%: three times higher than the non-disabled population. Although pharmacological therapy is frequently prescribed for this population, there is a lack of evidence underpinning these interventions. Likewise, there is a paucity of evidence regarding the different behavioural self-management programmes for people with ID.

Conducting randomised control trials (RCTs) is a complex process. However, conducting RCTs with hard-to-reach populations poses additional methodological and clinical challenges. In order to address the sparse evidence base of these pharmacological and behavioural interventions, more RCTs are needed.

Objective: This poster has two objectives. Firstly, to highlight the methodological barriers to conducting diabetes RCTs with people with ID. Secondly, to identify strategies to overcome methodological barriers faced in undertaking RCTs with hard-to-reach populations.

Methods: A systematic review of the ID RCT literature, spanning 15 yrs, was conducted exploring the frequency of trials for people with diabetes, the methodological challenges inherent in conducting this research and strategies to overcome them.

Results: No diabetes pharmacological or behavioural RCTs were conducted with an ID population. The review highlighted a number of methodological challenges identified from trials in other areas with those with ID including identification/recruitment, consent, capacity and the use of proxy informants. A number of creative and effective strategies for addressing these methodological challenges were identified.

Conclusions: Whilst the RCT literature within the fields of diabetes and ID are growing separately, this poster offers guidance on how to overcome a range of methodological challenges faced by trialists, thereby enhancing opportunities to include people with ID and other hard-to-reach populations in future trials. This review will inform methodology underpinning diabetes pharmacological and behavioural trials with ID and potentially other hard-to-reach populations.