NEW YORK (Reuters Health) - Despite some concerns over the effect type 1 diabetes might have on the brain, the condition does not appear to hinder children's school performance, new research shows.

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.

In the new study, researchers at the University of Iowa in Iowa City 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.

Diabetic children did have more absences and behavioral problems than their siblings did, but these differences seemed to have minimal effects academically, Dr. Ann Marie McCarthy and her colleagues report in the January issue of Pediatrics.

Type 1 diabetes was once known as juvenile diabetes because it typically arises in childhood. It occurs when the immune system mistakenly destroys the insulin-producing cells of the pancreas. Insulin is a hormone that helps move sugar from the blood into cells to use as fuel. 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.

In this study, children with better control over their blood sugar--based on medical records--showed better academic performance than their peers with poorer blood sugar management. However, the researchers point out, this could mean that ``brighter'' children are better able to manage their diabetes.

The diabetic children in this study were typically taking two insulin shots a day. McCarthy's team notes that children on more intensive therapy may experience more episodes of low blood sugar, which could have a greater impact on their school performance.

The investigators conclude that such children will need to be monitored to ensure that their learning is not hindered by these blood sugar drops, particularly if diabetic seizures or coma develop.

SOURCE: Pediatrics 2002;109.

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