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School Problems for Children with Type 1 Due
to Other Factors
posted 02/12/03
Differences in academic performance
between diabetic and non-diabetic children stem mostly from other factors, such
as family income and behavioral problems.
The chronic
fluctuations in blood sugar levels that mark type 1 diabetes--along with the
strains of managing a lifelong disease--have been associated with deficits in
certain skills such as memory and verbal abilities.
But studies have
yielded conflicting results in terms of which skills are affected, and whether
any of these deficits hurt children's school performance has been unclear.
Recently, researchers
found that children with type 1 diabetes performed as well as--and sometimes
better than--their siblings and classmates on standardized academic tests. Their
grades in math and reading were also comparable.
Now, "The overall
findings suggest the medical variables have less effect on academic achievement
than do factors such as (family income) and behavior problems for most children
with diabetes," the authors write.
Type 1 diabetics must
inject synthetic insulin daily--a regimen that often leads to wide fluctuations
in blood sugar levels. It has been suggested that these highs and lows may
hinder children's learning in school.
During the study,
reported in the January issue of Diabetes Care, Dr. Ann Marie McCarthy
and her colleagues examined standardized test scores, grades, behavior reports
and absences in 244 students between 8 and 18 years old with type 1 diabetes.
The researchers also looked at students' medical records, which detailed when
they developed diabetes and other aspects of their conditions.
McCarthy and her team
discovered that, contrary to previous suggestions, how well students did in
school was more closely related to their behavior problems and family income
than to the seriousness of their diabetes.
But not all aspects of
their conditions were free from influence: the researchers also found that
children who do a relatively poor job of keeping their blood sugar under control
had lower reading scores and grades than other children. This finding remained
even after McCarthy and her colleagues removed the influence of family income.
However, the
researchers point out, this could mean that children who do better in school are
also better able to manage their diabetes, suggesting that diabetes itself still
may not affect school performance.
McCarthy and her team
also discovered that children who end up in the hospital as a result of not
managing their blood sugar properly tended to score lower on standardized tests
than kids who control their blood sugar and are hospitalized less often.
The researchers also
discovered that a small group of students who monitor their blood sugar closely
and take small doses of insulin each day, but are hospitalized as a result of a
drop in sugar levels, received particularly low scores on the standardized
tests. These students may need special attention, McCarthy and her team note.
"Close monitoring of these high-risk children should be a priority in minimizing long-term cognitive effects of diabetes and its treatment," they write.
Source: Diabetes In Control Dot Com: Diabetes Care 2003;26:112-117.
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