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Children in Aotearoa with type 1 diabetes have significantly poorer educational outcomes than those without, new University of Otago-led research shows.

Nick Bowden
Dr Nick Bowden.

The research, a collaborative project funded by Cure Kids, with researchers from Otago, the universities of Canterbury and Waikato and Te Whatu Ora Waikato, analysed educational and health data of 442,320 children born in New Zealand between 1993 and 2001; 2,058 (0.47 per cent) of whom have type 1 diabetes (T1D).

The group is calling for more equitable health and educational support to help these children achieve their learning goals.

Lead author Dr Nick Bowden, of the Department of Women’s and Children’s Health, says the results show T1D is associated with poorer educational outcomes across all measures employed in the study: attendance, NCEA attainment, and university enrolment.

Children with T1D were less likely to obtain any NCEA qualification (3 per cent lower than those without T1D), and to enrol in university (7 per cent lower). Differences were more pronounced with respect to NCEA Level 3 attainment (12 per cent lower) and regular school attendance levels (9 per cent lower).

It was those children who were hospitalised with complications from their illnesses whose education was most affected. They had the lowest rate of any NCEA attainment (9 per cent lower than those without T1D), NCEA Level 3 attainment (24 per cent lower), regular attendance (34 per cent lower), and tertiary enrolment (16 per cent lower).

Among Māori and among Pacific young people, there was also evidence of the impact of T1D. Māori with T1D were significantly less likely to obtain NCEA Level 3 than Māori without T1D. Pacific with T1D were significantly less likely to obtain any NCEA qualification than Pacific without T1D. This is important because Māori and Pacific already experience inequitable educational outcomes compared to non-Māori/non-Pacific students.

“Unlike some other international studies undertaken on this subject, our study showed consistent findings across the board. These results highlight a further aspect of the profound impact of diabetes on the developing brain and psychosocial development,” Dr Bowden says.

The high number of T1D students who attained some level of NCEA , despite lower school attendance, was proof educational attainment could be achieved among this group, but the study evidenced that more support was needed, he says.

Ben Wheeler
Professor Ben Wheeler.

Co-author Professor Ben Wheeler, a paediatric endocrinologist in Otago’s Department of Women’s and Children’s Health says diabetes is a huge deal for New Zealand and worldwide – almost 300,000 New Zealanders have diabetes of one form or another.

“People with diabetes urgently need access to the best available therapies, as well as nursing, schooling and psychosocial support. For T1D this includes access to the latest technology, which is now the management gold standard internationally, but only available in New Zealand to those who can pay for it privately. Ensuring equity of access to new therapies and appropriate supports is an urgent challenge.”

Ensuring policymakers, school leaders and teachers are mindful of the needs and potential impacts of chronic illness on students’ access to curriculum content, particularly in relation to high stakes leaver assessments should be a priority.

“Proactive measures with adequate resourcing to support student achievement and success, including embedding and sustaining a whole-school approach to the promotion of student well-being is required,” Professor Wheeler says.

“Ongoing efforts are needed to ensure barrier-free access to education for young people with T1D, including school based supports to enable student achievement and success, and achieve equitable outcomes for indigenous populations.”

Publication details

Associations between type 1 diabetes and educational outcomes: an Aotearoa/New Zealand nationwide birth cohort study using the Integrated Data Infrastructure
Nicholas Bowden, Rachael Dixon, Vivienne Anderson, Martin de Bock, Alisa Boucsein, Maria Kewene-Edwards, Sheree Gibb, Jesse Kokaua, Octavia Palmer, Ryan Paul, Barry Taylor, Hien Vu and Benjamin J. Wheeler

For more information, please contact:

Professor Ben Wheeler
Department of Women’s and Children’s Health
University of Otago

Dr Nick Bowden
Department of Women’s and Children’s Health
University of Otago

Jessica Wilson
Adviser Media Engagement
University of Otago
Mob +64 21 279 5016

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