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Aims: The objective of the study was to compare grade point averages (GPAs) on compulsory school exit exams (exam GPA) and educational attainment at age 16 and 20 for individuals with and without type 1 diabetes. Methods: This study was a population‐based retrospective cohort study, which included the 1991 to 1998 birth cohorts in Denmark. Follow‐up was conducted at age 16 and 20 (follow‐up period; 1 January, 2007 to 31 December, 2018). There were 2083 individuals with and 555,929 individuals without type 1 diabetes. Linear regression and generalized linear models compared outcomes with and without adjustments for socio‐economic characteristics. Results: A total of 558,012 individuals (51% males) were followed to the age of 20. Having type 1 diabetes was associated with a lower exam GPA when adjusting for socio‐economic status (difference: −0.05 (95% CI, −0.09 to −0.01), a higher relative risk of not completing compulsory school by age 16 (1.37, 95% CI, 1.22 to 1.53)), and a higher relative risk of not completing or being enrolled in upper secondary education by age 20 (1.05, 95% CI, 1.00 to 1.10). Haemoglobin A1c (HbA1c) <58 mmol/mol (7.5%), >7 BGM/day and insulin pump use were associated with better educational achievement. Conclusion: Type 1 diabetes was associated with a marginally lower exam GPA and a higher risk of not completing compulsory school by age 16 and lower educational attainment by age 20. The findings were modified by HbA1c, BGM and insulin pump use. [ABSTRACT FROM AUTHOR]

Objective: Type 1 diabetes is associated with an increased risk of psychiatric morbidities. We investigated predictors and diabetes outcomes in a pediatric population with and without psychiatric comorbidities.Research Design and Methods: Data from the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids) and National Patient Register were collected (1996-2015) for this population-based study. We used Kaplan-Meier plots to investigate whether age at type 1 diabetes onset and average glycated hemoglobin (HbA1c) levels during the first 2 years after onset of type 1 diabetes (excluding HbA1c at debut) were associated with the risk of being diagnosed with a psychiatric disorder. Mixed-effects linear and logistic regression models were used to analyze HbA1c, BMI, severe hypoglycemia (SH), or ketoacidosis as outcomes, with psychiatric comorbidities as explanatory factor.Results: Among 4,725 children and adolescents with type 1 diabetes identified in both registers, 1,035 were diagnosed with at least one psychiatric disorder. High average HbA1c levels during the first 2 years predicted higher risk of psychiatric diagnoses. Patients with psychiatric comorbidity had higher HbA1c levels (0.22% [95% CI 0.15; 0.29]; 2.40 mmol/mol [1.62; 3.18]; P < 0.001) and an increased risk of hospitalization with diabetic ketoacidosis (1.80 [1.18; 2.76]; P = 0.006). We found no associations with BMI or SH.Conclusions: High average HbA1c levels during the first 2 years after onset of type 1 diabetes might indicate later psychiatric comorbidities. Psychiatric comorbidity in children and adolescents with type 1 diabetes increases the risk of poor metabolic outcomes. Early focus on the disease burden might improve outcomes. [ABSTRACT FROM AUTHOR]

Background: Managing the chronic illness type 1 diabetes (T1D) is extremely demanding, especially during adolescence. Self‐efficacy is belief in one’s own capabilities and this is crucial for diabetes management. Having a valid method for measuring self‐efficacy is important. Objective: Our aims were to psychometrically validate a Danish version of the self‐efficacy in diabetes management (SEDM) questionnaire, and to examine the relationship between background variables and self‐efficacy. Methods: All Danish adolescents with T1D (n = 1075) were invited to participate in our study. In total, 689 agreed to participate and 602 completed the study. Data were collected using a web‐based survey. All participants were asked to provide a blood sample for HbA1c measurement. Graphical log‐linear Rasch modeling (GLLRM) was used to validate the questionnaire and its reliability was assessed using Monte Carlo simulation. Results: We found the questionnaire to be valid and reliable, but it had a dual structure that suggested a need for 2 separate subscales. One subscale related to practical (SEDM1) and the other to emotional (SEDM2) aspects of diabetes management. Both subscales were targeted toward adolescents with lower self‐efficacy and were associated with HbA1c. SEDM1 was influenced by treatment modality and age. In SEDM2 we found an interaction between age and sex. Conclusion: The Danish version of the SEDM questionnaire should be divided into two parts, each with a valid and reliable subscale for self‐efficacy measurement. The relationship between self‐efficacy and age seems to differ between boys and girls. [ABSTRACT FROM AUTHOR]