Association of type 1 diabetes and school wellbeing: a population-based cohort study of 436,439 Danish schoolchildren
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ARTICLE
Association of type 1 diabetes and school wellbeing: a population-based cohort study of 436,439 Danish schoolchildren Tine M. Eriksen 1
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Amanda Gaulke 2
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Peter R. Thingholm 3
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Jannet Svensson 4
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Niels Skipper 5
Received: 14 May 2020 / Accepted: 4 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aims/hypothesis We aimed to examine the association of type 1 diabetes with school wellbeing among Danish children. Methods This is a population-based cohort study involving 436,439 Danish children, of which 1499 had a confirmed diagnosis of type 1 diabetes. The children were enrolled in grade levels 4 to 9 (middle school) in Danish public schools in the years 2014– 2017. Questionnaire outcomes from the yearly National Wellbeing Survey related to self-efficacy, perceived competences, peer and teacher support, bullying and somatic symptoms were analysed. Ordered logistic regression was used to compare outcomes of children with and without type 1 diabetes, and to compare subgroups of children with type 1 diabetes by different levels of HbA1c and diabetes duration. Primary outcomes were answers to seven pre-specified questionnaire items (scale, 1 to 5). Results A total of 817,679 questionnaires were initiated, of which n = 2681 were from children with type 1 diabetes. Compared with the background population, children with type 1 diabetes expressed more peer support; adjusted OR 1.17 (95% CI 1.08, 1.27). Children with diabetes also reported more often having a headache; adjusted OR 1.09 (95% CI 1.00, 1.19). Overall, children with poor glycaemic control (HbA1c >70 mmol/mol) had worse outcomes on the wellbeing measures compared with the background population. Even after adjusting for socioeconomic status, they still reported significantly worse perceived competences, less teacher support and more somatic symptoms (stomach ache and headache). Conclusions/interpretation In Denmark, children with type 1 diabetes generally feel well supported in school but have more headaches than other children. Poor glycaemic control is associated with worse psychological school-related wellbeing.
Keywords Child development . Denmark . Glycaemic control . Survey . Type 1 diabetes . Wellbeing Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00125-020-05251-z) contains supplementary material, which is available to authorised users. * Niels Skipper [email protected] 1
VIVE—The Danish Center for Social Science Research, Copenhagen, Denmark
2
Department of Economics, Kansas State University, Manhattan, KS, USA
3
Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
4
Copenhagen University Hospital, Herlev, Denmark
5
Department of Economics and Business Economics, Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Fuglesangs Allé 4, 8210 Aarhus V., Denmark
Abbreviations DanDiabKids DKA IPIP NWS pp SES TCMS
Danish Registry of Childhood and Adolescent Diabetes Diabetic ketoacidosis Internationa
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