Academic abilities and glycaemic control in children and young people with Type 1 diabetes mellitus

AimsTo determine if children and young people aged < 23 years with Type 1 diabetes differ in academic ability from age-matched control subjects without Type 1 diabetes and whether academic scores are related to glycaemic control. MethodsUsing a cross-sectional study design, we administered cognitive and academic tests (Woodcock-Johnson III Spatial Relations, General Information, Letter-Word Recognition, Calculation and Spelling tests) to young peoplewith Type 1 diabetes (n=61) and control subjects (n=26) aged 9-22 years. The groups did not differ in age orgender. Participants with Type 1 diabetes had a disease duration of 5-17.7 years. History of glycaemic control(HbA(1c), diabetic ketoacidosis and severe hypoglycaemic episodes) was obtained via medical records and interviews. ResultsThe participants with Type 1 diabetes had a lower mean estimated verbal intelligence (IQ) level compared with those in the control group (P=0.04). Greater exposure to hyperglycaemia over time was associated with lower spelling abilities within the group with Type 1 diabetes (P=0.048), even after controlling for age, gender, socio-economic status, blood glucose level at time of testing and verbal IQ (P=0.01). History of severe hypoglycaemia or ketoacidosis was not associated with differences in academic abilities. ConclusionsIn children and young people, Type 1 diabetes was associated with a lower verbal IQ. Moreover, increased exposure to hyperglycaemia was associated with lower spelling performance. These results imply that hyperglycaemia can affect cognitive function and/or learning processes that may affect academic achievement. What's new? Children and young people aged < 23 years with Type 1 diabetes performed less well on verbal intelligence tests than healthy control subjects. Subjects with greater exposure to hyperglycaemia had a lower spelling performance than those with less degree of hyperglycaemia exposure. Effects on spelling performance were not explained by age, gender, IQ, socio-economic status or blood glucose values at time of testing.