No significant difference was found between the standardized reading and math test scores of children with type 1 diabetes (T1D) and those without, according to study results published in JAMA, although these results may not be applicable to other countries where access to health care is impacted by socioeconomic status.
This population-based, retrospective cohort study examined the standardized test scores of Danish public school children in grades 2, 3, 4, 6, and 8 from January 2011 through December 2015 (math scores: n = 524,764; reading scores: n = 1,037,006). Students were identified through Statistics Denmark and diabetes information was obtained from the DanDiabKids national database. The primary outcome was the pooled reading and math test score. Outcomes were assessed with and without socioeconomic characteristic adjustments using linear regression models.
Out of 631,620 children attending public school, 2031 had a confirmed T1D diagnosis and 608,655 took at least 1 test. The mean age of participants was 10.31 ± 2.42 years and 51% were male. The overall combined math and reading score was 56.11 ± 24.93, and no significant differences in scores were found between children with T1D (mean, 56.56) and children without diabetes (mean score, 56.11; difference, 0.45 [95% CI, -0.31 to 1.22]). Using a linear regression model with adjustments for test topic, grade, and year, the estimated difference in scores between children with T1D and without was 0.24 (95% CI, -0.90 to 1.39); with additional adjustment for socioeconomic characteristics, the difference was 0.45 (95% CI, -0.58 to 1.49).
The researchers noted that for children with diabetes, a linear and statistically significant association between test scores and diabetes control, assessed by level of glycated hemoglobin, was found.
Limitations to the study included more missing test scores for children with diabetes and a short disease duration in the children tested (average duration, 4.5 years).
The study investigators concluded that no significant difference is discernable between the scores of standardized reading and mathematics tests taken by Danish children with T1D vs children without T1D. However, these results may not apply to other countries due to the widespread diabetes awareness and quality medical and social care available in Denmark, regardless of socioeconomic status.
Skipper N, Gaulke A, Sildorf SM, Eriksen TM, Nielsen NF, Svensson J. Association of type 1 diabetes with standardized test scores of Danish schoolchildren. JAMA. 2019;321(5):484-492.