Childhood‐onset type 1 diabetes and attention‐deficit/hyperactivity disorder with educational attainment: A population‐based sibling‐comparison study

• Published in: Acta Paediatrica 2022-11, Vol.111 (11), p.2131-2141
• Main Authors: Liu, Shengxin, Larsson, Henrik, Lichtenstein, Paul, Ludvigsson, Jonas F., Gudbjörnsdottir, Soffia, Serlachius, Eva, Kuja‐Halkola, Ralf, Butwicka, Agnieszka
• Format: Article
• Language: English
• Subjects: Academic Success; Adolescent; adolescents; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention deficit hyperactivity disorder; Child; Childhood; Children; Diabetes; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - epidemiology; Educational Status; glycemic control; Humans; Hyperactivity; Medicin och hälsovetenskap; Pediatrics; Pediatrik; Population studies; Population-based studies; prevalence; Regression analysis; Siblings
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/apa.16500

Aim To examine the association of childhood‐onset type 1 diabetes (T1D) and attention‐deficit/hyperactivity disorder (ADHD) with educational outcomes from compulsory school to university. Methods Using multiple Swedish nationwide registers, we followed up on 1,474,941 individuals born in Sweden from 1981–1995 to December 31, 2013. Associations of T1D and ADHD with achieving educational milestones (from compulsory school to university) and school performances were estimated using logistic and linear regression models and sibling comparison models. Results Compared to their peers, children with both T1D and ADHD were less likely to achieve any of the educational attainments, including completing compulsory school (adjusted OR [aOR] [95% CI]: 0.43 [0.26, 0.72]), be eligible to and finishing upper secondary school (0.26 [0.19, 0.36], 0.24 [0.17, 0.35], respectively), and starting university (0.38 [0.17, 0.90]). The odds of achieving these educational milestones were substantially lower in children with ADHD alone (aORs: 0.14–0.44), but were slightly worse or no differences in children with T1D alone (aORs: 0.86–1.08). All associations above remained similar in the sibling comparison models. Conclusion Children and adolescents with both T1D and ADHD had long‐term educational underachievement, with ADHD being the major contributor. Our findings suggest the importance of assessing ADHD in children with T1D and targeted support for minimising the education gap between the affected children and their peers.