Children with type 1 diabetes miss more school than their peers without this condition, but the good news is these absences don't have to affect their grades or chances of going on to college, new research shows.
Kids who had the tightest control of their diabetes missed seven sessions a year, while those who had challenges managing their blood sugar levels were absent for 15 sessions a year, U.K. researchers found. (Sessions are defined as a half day in the study.)
“The most important thing is that children with type 1 diabetes are doing really well, on average, even though they are missing more school and have more challenges than kids without type 1 diabetes,” said study author Robert French. He is a senior research fellow at Cardiff University's School of Medicine in Wales. “The burden on the family and children is huge, but they are keeping up.”
Shelby Sangha was diagnosed with type 1 diabetes at age 17 and struggled in school as a result. Now 23, she works for an ambulance service as an emergency medical dispatcher in England.
"School and exams were a whirlwind, a very big emotional roller coaster,” she said in a university news release. “I didn't want to believe I had diabetes or need treatment because my friends didn't — so why should I? I kind of pushed it to the back of my mind and tried to forget about it.”
Sangha received little support from her school.
“Schools and health care teams need to work together to provide more support to children and their families,” French suggested. "This will ensure that children living with diabetes can thrive and reach their full academic potential."
Type 1 diabetes is an autoimmune condition that occurs when the pancreas produces little to no insulin. Insulin is needed to help blood sugar, or glucose, enter the cells, where it is used for energy. When insulin is in short supply, glucose can build up, causing such symptoms as extreme fatigue, blurry vision, weight loss and confusion. People with type 1 diabetes must take synthetic insulin throughout the day to keep blood sugar and symptoms in check.
The study wasn't designed to find out why these kids are missing school. “In general, kids miss about five sessions for routine doctor's appointments, and then and on top of that, there are additional sick days related to diabetes,” French said.
For the study, the researchers compared absences among just over 1,200 children with diabetes and over 263,000 peers without diabetes. Kids in the study were aged 6 to 18. The investigators also looked at average blood sugar levels in children with type 1 diabetes.
Those who had less control of their blood sugar levels tended to miss more school, get worse grades and were less likely to go to college, the study found. Diabetes itself does not appear to affect cognitive function, he said. Instead, lack of family support and socioeconomic factors are likely drivers of both higher blood sugar and poorer educational outcomes, French said.
The study was published Dec. 1 in Diabetes Care.
The new findings reflect what Dr. Christina Reh sees in her U.S. practice. She is an endocrinologist at the University of California, Los Angeles, and director of the diabetes program at UCLA Westwood Center.
“Children who are struggling with mental issues, difficult family dynamics and other barriers to care are those who have highest A1C levels,“ said Reh, who reviewed the new study. A1C testing provides a snapshot of blood sugar levels over time. “These patients may be more likely to be struggling in school as well."
The article is reassuring, she said. “Kids with diabetes have similar academic outcomes to children without diabetes,” Reh noted.
Some absences are unavoidable for these kids, she added. “Most patients, even with good management of diabetes, need to see their endocrinologist ideally four times per year for routine visits,“ Reh said. “In addition, even in well-managed diabetes, children can have other sick days occur related to diabetes.”
The American Diabetes Association offers more on living with type 1 diabetes.
SOURCES: Robert French, PhD, senior research fellow, Cardiff University School of Medicine, Cardiff, U.K.; Christina Reh, MD, endocrinologist, University of California, Los Angeles, director, diabetes program, UCLA Westwood Center; Diabetes Care, Dec. 1, 2022