Factors Associated With Academic Achievement in Children With Type 1 Diabetes

Abstract

OBJECTIVE -To examine academic achievement in children with diabetes and to identify predictors of achievement. RESULTS -Reading scores and GPA were lower for children with poor metabolic control than for children with average control. Children with hospitalizations for hyperglycemia had lower overall achievement scores than children with better metabolic control and fewer hospitalizations for hyperglycemia. The small group of children with tight metabolic control and hypoglycemic hospitalizations scored particularly low on the ITBS/ITED. Other variables had less clear relationships with academic achievement. Neither early onset of diabetes nor frequent school absence was associated with lower scores on the ITBS/ITED. Sex comparisons found that boys performed better than girls only in math. Socioeconomic status and parent ratings of behavior problems were significantly correlated with academic achievement, but medical variables added only slightly to predictive precision. RESEARCH DESIGN AND METHODSCONCLUSIONS -For most children with diabetes, medical variables are not as strongly associated with academic achievement as are factors such as socioeconomic status and behavioral factors. Poor metabolic control and serious hypoglycemia, however, are a potential concern for a subset of these children.

Impact of type 1 diabetes mellitus on academic performance

“…Diabetes has been shown to impair intelligence, memory, attention and understanding in children and adolescents, [13][14][15] as well as verbal (and therefore overall) intelligence quotient. 16 Type 1 diabetes is associated with cognitive deficits in adolescents, independent of the quality of metabolic control and the duration of disease.…”

Experimental Diabetes Attenuates Cerebral Cortical−Evoked Forelimb Motor Responses

“…Impairment of the CNS in diabetic patients, referred to in some studies as diabetic encephalopathy, is relatively unknown and as a result its pathogenesis is understudied. Subtle neuropsychological deficits observed in some children with type 1 diabetes have raised reasonable concerns about the effect this disease may have on cognitive development in school-age children (31,32). Mental and motor slowing have also been reported among both type 1 and type 2 adult diabetic subjects (33)(34)(35), and impaired central motor conduction, assessed by magnetic stimulation, in diabetic patients has been described (6,7).…”

School performance in children with type 1 diabetes—a population-based register study

“…The DCCT applicability for childhood-onset cases has therefore been discussed [9,10] and the incidence of hypoglycaemia in childhood diabetes has been shown to have increased over the past decade [11]. The reduction of HbA 1c using intense insulin treatment regimens with simultaneous avoidance of frequent hypoglycaemic episodes that might affect child development and school performance is therefore a major challenge in child diabetes care [10][11][12][13], especially as poor metabolic control also seems to be associated with learning capacity deficiencies [14].…”