Type 1 diabetes

Children’s school performance is not impaired by type 1 diabetes

Primary school aged children with type 1 diabetes have educational outcomes similar to their peers without diabetes, according to a South Australian study.

The findings should alleviate concerns about blood glucose variability, impaired cognitive function and diabetes-related school absences may adversely affect academic ability, according to researchers at Adelaide University.

Their comparison of year 5 NAPLAN scores for numeracy and literacy in 61,445 children, including a subset of 162 children with type 1 diabetes, found negligible differences between those with and without diabetes.

The study found differences in mean reading, writing and numeracy scores of the children with and without T1D were around one tenth of a standard deviation – equivalent to less than one mark in the raw NAPLAN assessment.

“For example, the mean reading score ±SD was 482.8±78.9 for children with T1D and 475.5±74.3 for children without T1D,” the study said.

It also found there were negligible differences in the mean reading, writing, spelling, grammar and numeracy scores according to time since their type 1 diabetes diagnosis.

“For example the mean reading score ±SD was 475.5±81.5 for children without T1D, 488.2±83.0 for recently diagnosed (≤2 years since T1D), and 480.2±75.4 for 3-10 years exposure to T1D.”

The findings were consistent with recent schools based performance studies from Western Australia and Denmark, but contrasted with other studies, including older studies, which used cognitive measures and IQ scores.

The study authors said it was thought T1D could potentially affect a child’s memory and concentration due to the challenges of managing blood glucose, even without overt hypo and hypo-glycaemia.

T1D could also have longer term effects on brain volumes and altered neural pathways, and they noted, that some children with T1D have shown lower executive functioning including planning, workingmemory, processing, attention, problem solving capacity, and visual motor integration.

“Improvements in T1D management, diabetes education programs for school staff, and perhaps increasing use of insulin pumps due to government subsidy in recent years may have helped children in achieving better glycaemic control,” they said.

They also noted that the legal obligation for schools to make reasonable adjustments to encourage participation of children with diabetes, may help them reach their potential and achieve similar educational outcomes as children without type 1 diabetes.

The authors, from the University of Adelaide, noted the study included only children attending public schools but that educational attainment was usually similar in both public and private schools after adjusting for socioeconomic status.

“This whole-of-population study demonstrated that South Australian children with T1D are not disadvantaged on educational outcomes in year 5 compared to children without T1D,” they concluded.

“This supports the idea that the negative effects of T1D on educational outcomes may have equalised possibly through improved T1D management in children.”

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