Association of type 1 diabetes and school wellbeing: a population-based cohort study of 436,439 Danish schoolchildren
Association of type 1 diabetes and school wellbeing: a population-based cohort study of 436,439 Danish schoolchildren
复制标题
DOI：
10.1007/s00125-020-05251-z
复制
发表时间：
2020-08-19
期刊：
影响因子：
8.2
通讯作者：
Skipper, Niels
中科院分区：
文献类型：
--
作者：
Eriksen, Tine M.;Gaulke, Amanda;Skipper, Niels
目的/假设我们旨在研究丹麦儿童1型糖尿病与学校健康的关系。方法：这是一项基于人群的队列研究，涉及436,439名丹麦儿童，其中1499名确诊为1型糖尿病。这些孩子于2014-2017年在丹麦公立学校就读4至9年级（中学）。研究人员分析了年度国民健康调查中有关自我效能感、感知能力、同伴和老师支持、欺凌和躯体症状的问卷调查结果。使用有序逻辑回归来比较患有和未患有1型糖尿病的儿童的结局，并通过不同水平的HbA（1c）和糖尿病病程来比较1型糖尿病儿童亚组。主要结果是对七个预先指定的问卷项目（量表，1至5）的回答。结果共发放问卷817,679份，其中2681份来自1型糖尿病患儿。与背景人群相比，1型糖尿病患儿表现出更多的同伴支持；调整OR 1.17 （95% CI 1.08, 1.27）。患有糖尿病的儿童也更常报告头痛；调整OR 1.09 （95% CI 1.00, 1.19）。总体而言，与背景人群相比，血糖控制不良（HbA(1c) bbb70 mmol/mol）的儿童在健康测量方面的结果更差。即使在调整了社会经济地位之后，他们仍然报告了明显更差的感知能力，更少的教师支持和更多的躯体症状（胃痛和头痛）。结论/解释在丹麦，1型糖尿病儿童通常感觉在学校得到了很好的支持，但比其他儿童更容易头痛。血糖控制不佳与学校心理健康状况较差有关。
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 HbA(1c)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 whichn = 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 (HbA(1c)>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.