title: School performance in children with type 1 diabetes: a contemporary population-based study.
abstract: OBJECTIVE
  Our aim was to examine the school performance of children with type 1 diabetes in comparison to their peers, exploring changes over time, and the impact of clinical factors on school performance.
  
  
  METHODS
  The study included data on 666 children with type 1 diabetes from the Western Australia Children's Diabetes Database. (WACDD), a population-based registry, and 3260 school and school year matched non-diabetic children. Records from the National Assessment Program - Literacy and Numeracy (NAPLAN) (2008-2011), which examines four educational outcome domains and is administered annually to all years 3, 5, 7, and 9 children in Australia, were sourced for both groups. Clinical data were obtained for the children with diabetes from the WACDD.
  
  
  RESULTS
  No significant difference was observed between those with type 1 diabetes and their peers, across any of the tested domains and school years analysed. No decline over time was observed, and no decline following diagnosis was observed. Type 1 diabetes was associated with decreased school attendance, 3% fewer days attended per year. Poorer glycaemic control [higher haemoglobin A1c (HbA1c)] was associated with a lower test score [0.2-0.3 SD per 1% (10.9 mmol/mol) increase in HbA1c], and with poorer attendance [1.8% decrease per 1% (10.9 mmol/mol) increase in HbA1c]. No association was observed with history of severe hypoglycaemia, diabetic ketoacidosis or age of onset and school test scores.
  
  
  CONCLUSIONS
  These results suggest that type 1 diabetes is not associated with a significant decrement in school performance, as assessed by NAPLAN. The association of poorer glycaemic control with poorer school performance serves as further evidence for clinicians to focus on improving glycaemic control.
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Australia.|Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Australia.
authors.forename: Matthew N
authors.initials: MN
authors.lastname: Cooper
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Australia.|Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Australia.
authors.forename: Kaitrin A R
authors.initials: KA
authors.lastname: McNamara
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Australia.|Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Australia.|The School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.
authors.forename: Nicholas H
authors.initials: NH
authors.lastname: de Klerk
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Australia.|Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Australia.|The School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Davis
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Australia.|Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Australia.|The School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Jones
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D000067010:Literacy / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D012574:Schools / Q000706:statistics & numerical data; D014904:Western Australia / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin
keywords: diabetes mellitus; education; type 1 diabetes mellitus