Summary

Childhood onset type 1 diabetes mellitus (T1DM) is associated with lower education, lower rates of employment, and lower employment earnings in both men and women in Sweden. This article discusses data from a registry study of young adults with childhood onset T1DM.

  • Diabetes Mellitus
  • Nursing
  • Diabetes & Endocrinology Clinical Trials
  • Diabetes Mellitus
  • Nursing
  • Endocrinology
  • Diabetes & Metabolic Syndrome
  • Diabetes & Endocrinology Clinical Trials

Childhood onset type 1 diabetes mellitus (T1DM) is associated with lower education, lower rates of employment, and lower employment earnings in both men and women in Sweden. Sofie Persson, MD, Lund University, Malmö, Sweden, presented data from a registry study of young adults with childhood onset T1DM.

Although the effect of T1DM on socioeconomic status is not well understood, lifestyle changes and complications related to childhood onset T1DM may result in greater rates of absenteeism and can decrease work capacity [Persson S et al. EASD 2013 (abstr 39)]. A previous study suggested that childhood onset T1DM had a negative impact on compulsory and secondary education [Persson S et al. Diabetologia 2013]. The purpose of this registry study was to examine the effect of childhood onset T1DM on rates of university-level education and labor market outcomes in early adulthood.

The study included 2485 patients in the Swedish Childhood Diabetes Register that were born between 1972 and 1978 and were diagnosed with T1DM at <15 years. The Swedish Childhood Diabetes Register is linked to other national registers, including the longitudinal integration database for health insurance and labor market studies (LISA). In addition, 9940 controls matched for birth year and residency at diagnosis were selected by Statistics Sweden. Annual earnings data were collected between 1990 and 2010, corresponding to ages 19 to 32 years. Statistics used in this study included linear, logistic, and panel data regression, and socioeconomic status and demographics were controlled.

Fewer women and men with childhood onset T1DM had a university-level degree at age 32 years compared with individuals from the general population (women: OR, 0.79; 95% CI, 0.69 to 0.92; men: OR, 0.81; 95% CI, 0.70 to 0.94). In addition, individuals with childhood onset T1DM were less likely to have continued their higher education for 3 or more years (women: OR, 0.79; 95% CI, 0.68 to 0.91; men: OR, 0.80; 95% CI, 0.68 to 0.94).

Rates of employment at age 32 years were lower in individuals with childhood onset T1DM compared with the general population (women: OR, 0.66; 95% CI, 0.53 to 0.81; men: OR, 0.63; 95% CI, 0.50 to 0.80). Individuals with childhood onset T1DM that were employed were likely to have lower earnings than the general population, at −13% lower for women (p=0.003) and −8% for men (p<0.002), a trend that appeared to begin in the early 20s (Figure 1). Persson pointed out that the impact of childhood onset T1DM on earnings appeared to rise with increasing duration of the disease. The negative impact was not observed until after a 16-year duration of T1DM.

Figure 1.

Earnings Through Early Adulthood in Patients With T1DM in Sweden

Reproduced with permission from S Persson, MD.

Prof. Persson indicated that, in her opinion, the data from the present study suggest that childhood onset T1DM has a negative impact on earning a higher education degree, gaining employment, and earnings among young adults. In general, women with T1DM experienced the greatest negative impact. She concluded that additional research is needed to determine the impact of T1DM on the labor market over a longer time period.

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