Reuters Health) - A study in Denmark showed that children living with type 1 diabetes were no different from their peers in their scores on reading and math tests.
The less common form of diabetes, known as type 1, develops in childhood or early adulthood when the pancreas does not produce the hormone insulin, which the body needs to convert blood sugar into energy.
Complications of type 1 diabetes, such as dangerous high blood sugar levels or dangerous low blood sugar levels, have been linked to cognitive problems. But not all studies link type 1 diabetes to worse academic performance, say researchers at JAMA.
For the current study, they examined reading and math scores on average more than 631,000 public school children in grades 2 to 8 in Denmark for five years. They found no significant difference in the mean test scores between 2,031 children with type 1 diabetes and other students in this study.
"As the father of a child with type 1 diabetes, I know there is a lot to worry about about diabetes," said study leader Niels Skipper of Aarhus University. "The message brought home here is that school performance should not be one of them, and that children with diabetes have the same learning and educational opportunities as their peers," Skipper said via email.
Children in the study took standard reading and math tests that ranged from 0 to 100.
Students with type 1 diabetes have lived with this disease for an average of 4.5 years and about two-thirds of them use insulin pumps.
The average test score for children with diabetes is 56.56, compared with 56.11 for children without diabetes. In the math test, the average score was 56.06 for students with diabetes and 55.68 for those without the condition. The average reading value was 56.81 with diabetes and 56.32 without it. These differences are too small to rule out the possibility that it was a coincidence.
However, the test results are below the average for diabetic students who have dangerous high blood sugar levels. Conversely, students with diabetes without very high blood sugar levels have an average score slightly above average.
This suggests that poor blood sugar control, and not just the diagnosis of diabetes itself, is what explains the potential cognitive problems for developing this disease, Dr. Andrew Budson, head of cognitive neurology and behaviors at the Boston Veterans Health System and a researcher at the Boston University School of Medicine.
Very high blood sugar levels can increase the risk of stroke, and this episode in turn can cause cognitive problems in diabetics, said Budson, who was not involved in the study, via email.
The conclusion "is that increasing stroke is the only reason why people with diabetes end up thinking and memory problems in middle or advanced life," Budson said.
"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 keep their blood sugar under control because that will reduce the risk of stroke," Budson advises.
This study was not designed to determine whether diabetes can cause cognitive problems or in what way, it is also not designed to assess stroke risk factors, events that are rare in children.
One limitation of this study is that students do not live with diabetes for so long when they take their standardized tests, and there is a possibility that academic performance can deteriorate over time, the study authors point out.
It is also possible that yields in Denmark, where there is great awareness of how to manage diabetes and government-funded medical care, do not reflect what will happen elsewhere.