Diabetes does not seem to affect test results in children

(Reuters Health) – A Danish study suggests that children with type 1 diabetes are no different from their peers in reading and math tests.

Type 1 diabetes, which is less common, called type 1, develops in childhood or in adulthood when the pancreas does not produce insulin, a hormone needed to convert blood sugar into energy.

The complications of type 1 diabetes – such as dangerously high blood sugar or dangerously low brain sugar levels – have been badociated with cognitive problems. But not all studies have linked type 1 diabetes to academic performance degradation, researchers say in JAMA.

In this study, they examined average scores in reading and mathematics of more than 631,000 public school students in grades 2 to 8 in Denmark over a five-year period. They found no significant difference in average test scores between the 2,031 children with type 1 diabetes and the rest of the study students.

"As a parent of a child with type 1 diabetes, I know that there is much to fear in diabetes," said the senior author of the study. study, Niels Skipper, from the University of Aarhus. "The message to remember here is that school performance should not be one of them and that diabetic children have the same opportunities for learning and education as their peers," said Skipper by email.

The children in the study pbaded standardized tests in reading and mathematics, rated from 0 to 100.

Students with type 1 diabetes had been living with the disease for 4.5 years on average and about two-thirds of them were using insulin pumps.

Overall mean test scores for diabetic children were 56.56, compared to 56.11 for non-diabetic children. In mathematics tests, the average scores were 56.06 for diabetic students and 55.68 for those who did not. Mean reading scores were 56.81 with diabetes and 56.32 without diabetes. These differences were too small to exclude the possibility that they were due to chance.

The test results, however, were below average for diabetic students whose blood sugar levels were dangerously high. In contrast, diabetic students without an extremely high blood sugar level had average scores slightly above average.

This suggests that inadequate control of blood glucose, not just the diagnosis of diabetes, is what could explain the risk of developing cognitive problems related to the disease, said Dr. Andrew Budson, Head of the Department of Cognitive and Behavioral Neurology of the Boston Veterans Affairs Health System. and researcher at the Faculty of Medicine at Boston University.

A dangerously high blood sugar can increase the risk of stroke, and these episodes can in turn cause cognitive problems in people with diabetes, said Budson, not involved in the study, by email.

The conclusion is "that increasing the number of strokes is the only reason why people with diabetes end up having problems with thinking and memory in the middle or at the end of their lives" said Budson.

"Now, people with diabetes of all ages know exactly what they need to do to keep their memory as strong as possible: they need to control their blood sugar levels as this will reduce their risk of stroke," he said. advised Budson.

The study was not designed to determine whether or how diabetes could directly cause cognitive problems, nor to badess the risk factors for stroke, a rare event in children.

One of the limitations of the study was that students had not lived with diabetes for as long as they had pbaded standardized tests, and academic performance may deteriorate over time, emphasize the authors of the study.

It is also possible that the results obtained in Denmark, which is better able to manage diabetes and government-funded health care, do not reflect what would happen elsewhere.

SOURCE: bit.ly/2UMG58p JAMA, online February 5, 2019.