Should more attention be paid to school performance in children and adolescents with diabetes?

Diabetes with onset in childhood and adolescence has consequences for the family and the child, and the negative health effects and burden of daily disease management are well known. Less is known about the socioeconomic consequences of the disease and how it impacts on school performance. In this issue of Diabetologia, Persson et al report from a Swedish study regarding the impact of childhood-onset type 1 diabetes on school performance (doi:10.​1007/​s00125-013-2870-8). Results indicate that onset of type 1 diabetes in childhood has adverse effects on school achievement and potentially on future successful employment. The authors suggest that attention must be paid in school to the particular needs of children with diabetes, although the question needs to be raised as to whether the differences are of such a magnitude that they matter and are relevant for healthcare and school personnel. The study provides a novel addition and is important because of the limited information available on educational performance among children and adolescents with diabetes. However, the results should be interpreted with caution because of the limitations of the study design, the relatively small differences detected and the fact that results from one country are not transferable to other countries without further research. The challenge is to find the resources to set up population-based studies in countries where appropriate data are available to investigate the long-term effects of type 1 diabetes on education and employment in different settings.