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Item #5
School
Problems for Children with Type 1 Due to Other Factors
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. Diabetes
Care 2003;26:112-117
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