Summary: Type 1 diabetes in either parent was associated with an increased risk of cognitive development problems and lower academic performance in children.
Cognitive development in children could be affected regardless of which biological parent has type 1 diabetes, according to research published April 19th in the open-access journal PLOS Medicine.
The research shows for the first time that having a parent with a chronic disease like type 1 diabetes may be associated with lower school performance rather than maternal high blood sugar during fetal development.
The influence of maternal diabetes during pregnancy on the cognition of their children has been widely researched. Glucose crosses the placenta and maternal high blood sugar, hyperglycemia, can affect fetal development including the baby’s brain.
There is little evidence on different diabetes subtypes and the effect of having a father with type 1 diabetes.
Anne Lærke Spangmose and colleagues from Copenhagen University Hospital, Denmark obtained data from Danish registers and also on test scores in math for grades three and six, and reading for grades two, four, six and eight.
The team included 622,073 children between 6-18 years old attending public schools over a seven-year period. There were 2,144 children with mothers with type 1 diabetes, 3,474 children with fathers with type 1 diabetes, and 616,455 children from the background population.
Children of mothers and fathers with type 1 diabetes had mean scores of 54.2 and 54.4 respectively, compared with mean scores of 56.4 in children from the background population.
The team acknowledge that having a parent suffering from a serious chronic disease like diabetes could cause stress and be detrimental to a child’s school performance. However this study suggests a different explanation for previously observed adverse effects of maternal type 1 diabetes during pregnancy on children’s cognitive development.
Spangmose adds, “Lower test scores in the offspring of mothers with type 1 diabetes appear to reflect a negative association of having a parent with type 1 diabetes rather than a specific adverse effect of maternal type 1 diabetes during pregnancy on the fetus. Our recent large Danish cohort study, including 622,073 children, has shown this.”
About this cognitive development and diabetes research news
Author: Claire Turner Source: PLOS Contact: Claire Turner – PLOS Image: The image is in the public domain
School performance in Danish children exposed to maternal type 1 diabetes in utero: A nationwide retrospective cohort study
Conflicting results have been reported concerning possible adverse effects on the cognitive function of offspring of mothers with type 1 diabetes (O-mT1D). Previous studies have included offspring of parents from the background population (O-BP), but not offspring of fathers with type 1 diabetes (O-fT1D) as the unexposed reference group.
Methods and findings
This is a population-based retrospective cohort study from 2010 to 2016. Nationally standardized school test scores (range, 1 to 100) were obtained for public school grades 2, 3, 4, 6, and 8 in O-mT1D and compared with those in O-fT1D and O-BP. Of the 622,073 included children, 2,144 were O-mT1D, and 3,474 were O-fT1D. Multiple linear regression models were used to compare outcomes, including the covariates offspring with type 1 diabetes, parity, number of siblings, offspring sex, smoking during pregnancy, parental age, and socioeconomic factors.
Mean test scores were 54.2 (standard deviation, SD 24.8) in O-mT1D, 54.4 (SD 24.8) in O-fT1D, and 56.4 (SD 24.7) in O-BP. In adjusted analyses, the mean differences in test scores were −1.59 (95% CI −2.48 to −0.71, p < 0.001) between O-mT1D and O-BP and −0.78 (95% CI −1.48 to −0.08, p = 0.03) between O-fT1D and O-BP.
No significant difference in the adjusted mean test scores was found between O-mT1D and O-fT1D (p = 0.16). The study’s limitation was no access to measures of glycemic control during pregnancy.
O-mT1D achieved lower test scores than O-BP but similar test scores compared with O-fT1D. Glycemic control during pregnancy is essential to prevent various adverse pregnancy outcomes in women with type 1 diabetes. However, the present study reduces previous concerns regarding adverse effects of in utero hyperglycemia on offspring cognitive function.