Association of type 1 diabetes and educational achievement in 16–20‐year‐olds: A Danish nationwide register study

Abstract

Aims:The objective of the study was to compare grade point averages (GPAs) on compulsory school exit exams (exam GPA) and educational attainment at age 16 and 20 for individuals with and without type 1 diabetes.Methods: This study was a population-based retrospective cohort study, which included the 1991 to 1998 birth cohorts in Denmark. Follow-up was conducted at age 16 and 20 (follow-up period; 1 January, 2007 to 31 December, 2018). There were 2083 individuals with and 555,929 individuals without type 1 diabetes.Linear regression and generalized linear models compared outcomes with and without adjustments for socio-economic characteristics.Results: A total of 558,012 individuals (51% males) were followed to the age of 20. Having type 1 diabetes was associated with a lower exam GPA when adjusting for socio-economic status (difference: −0.05 (95% CI, −0.09 to −0.01), a higher relative risk of not completing compulsory school by age 16 (1.37, 95% CI, 1.22 to 1.53)), and a higher relative risk of not completing or being enrolled in upper secondary education by age 20 (1.05, 95% CI, 1.00 to 1.10). Haemoglobin A1c (HbA1c) <58 mmol/mol (7.5%), >7 BGM/day and insulin pump use were associated with better educational achievement. Conclusion:Type 1 diabetes was associated with a marginally lower exam GPA

Educational Outcomes in Children and Adolescents With Type 1 Diabetes and Psychiatric Disorders

“…Although academic attainment in children and adolescents with T1D has been of research interest, results from prospective studies have been inconclusive. In line with several recent population-based studies, we observed that those with T1D alone had minor academic underachievement and marginally worse compulsory school performance than their healthy peers.…”

“…One important aspect is educational attainment, which is a determinant for various life course consequences, such as socioeconomic status and overall adulthood health. 9,10 Several populationbased studies [11][12][13][14][15] found that T1D alone was associated with increased risks of school absenteeism, lower examination scores, and adulthood unemployment. However, there remains a distinct lack of studies examining educational outcomes in children and adolescents with comorbid T1D and psychiatric disorders.…”

Variance of concern

“…Data from Denmark suggest that in young people, type 1 diabetes is associated with a lower grade point average, less school completion and lower participation in higher education, while a lower HbA1c, increased frequency of self monitoring and insulin pump therapy are associated with a higher educational achievement. 8 These associations may be difficult to unpick but highlight that there is a relationship between educational attainment, type 1 diabetes and glycaemia, and that optimising education and glycaemia may be seen as complementary for children and young adults with increased partnership needed between health services and schools. The positive associations between self monitoring, pump therapy and a lower HbA1c with educational attainment suggest that education and support empowering more effective self management may have broader education benefits.…”

School Performance Among a Sample of Type1 Diabetic Children and Adolescents in Erbil City

“…Childhood with T1DM has been demonstrated to impair brain function in several ways and the brain is metabolically active organ may be affected by glucose instability (13). Chronic hyperglycemia, repeated severe hypoglycemia, and ketoacidosis have all been demonstrated to affect the brain and have an effect on academic outcomes (14). Moreover, T1DM has an impact on practically every aspect of a diabetic child's life, including their cognitive and academic ability.…”

“…According to several studies, T1DM is linked to decreased neuronal function, which eventually results in cognitive impairment in domains like intelligence, learning, memory, information processing, attention, executive function, visual-motor integration, and academic achievement (6,15,16). According to teacher evaluations and school records in the United States that looked into educational issues in T1DM children discovered that they had lower academic competence ratings, a tendency to pay less attention in class, and more missing school days than their healthy siblings (14,17,18). Furthermore, (17) in Sudan revealed that, T1DM is the most common endocrine disorder in children.…”