title: Impact of childhood-onset type 1 diabetes on schooling: a population-based register study.
abstract: OBJECTIVE
  We investigated the impact of type 1 diabetes on educational achievements in compulsory and upper secondary school, as well as potential long-lasting effects.
  
  
  METHODS
  Altogether 2,485 individuals with type 1 diabetes, diagnosed at the age of <15 years and born in 1972-1978, were selected from the Swedish Childhood Diabetes Register, which was linked to national population registers including the Swedish Education Register. For each individual, four controls from the general population, matched for year of birth and residence at the time of diagnosis, were selected by Statistics Sweden (n = 9,940). We analysed the impact of diabetes on final school grades at 16 years (compulsory school) and 19 years (upper secondary school) and on participation in the labour market at 29 years using linear, logistic, ordered logistic and quantile regression analyses, controlling for demographics and socioeconomic background.
  
  
  RESULTS
  Diabetes had a negative effect on mean final grades (scale of 1-5) in compulsory school (-0.07, p < 0.001) and theoretical programmes in upper secondary school (-0.07, p = 0.001). Children with early-onset diabetes (0-4 years) suffered a greater disadvantage as a result of the disease (-0.15, p = 0.001 in compulsory school). The strongest effect was seen in the lowest deciles of the conditional distribution on mean final grades. At age 29, individuals with diabetes were less likely to be gainfully employed (OR 0.82, 95% CI 0.73, 0.91).
  
  
  CONCLUSIONS
  The small but significant negative effect of type 1 diabetes on schooling could affect opportunities for further education and career development. Attention must be paid in school to the special needs of children with diabetes.
authors: Health Economics Unit, Department of Clinical Sciences, Malmö, Lund University, 205 02 Malmö, Sweden. sofie.persson@med.lu.se
authors: S
authors: S
authors: Persson
authors: G
authors: G
authors: Dahlquist
authors: U-G
authors: UG
authors: Gerdtham
authors: K
authors: K
authors: Steen Carlsson
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000503:physiopathology*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D012042:Registries; D012044:Regression Analysis; D012574:Schools; D013548:Sweden; D016896:Treatment Outcome; D055815:Young Adult