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Glucose Metrics During School Hours in Primary School-Aged Children With Type 1 Diabetes: A Population-Based Cohort Study

AI Summary
  • Higher time in range (3.9-10.0 mmol/L) during school (58.0%) than holidays (53.5%) and weekends (56.6%).
  • Lower mean sensor glucose, SD and time above range (>10 and >13.9 mmol/L) during school versus holidays and weekends.
  • Hypoglycaemia <3.9 mmol/L slightly higher during school than holiday weekdays but remained under 4% across periods; no difference <3.0 mmol/L.
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J Paediatr Child Health. 2026 Jun 6. doi: 10.1111/jpc.70463. Online ahead of print.

ABSTRACT

AIM: School time represents a significant component of overall glycaemia for children with type 1 diabetes (T1D), and glucose levels during instructional time may be important for optimising academic progress. There is, however, limited literature regarding glycaemia during school hours. This study aimed to evaluate glucose levels during school in primary school-aged children with T1D in Western Australia (WA) and to compare these with non-school days.

METHODS: A 12-week cross-sectional cohort study was performed comprising a WA school term and subsequent school holidays, utilising demographic, clinical and continuous glucose monitor data from the WA Children’s Diabetes Database for primary school children with > 1 year of diagnosis of T1D.

RESULTS: A total of 235 children, mean age 9.54 ± 1.67 years and duration of T1D of 4.08 ± 2.31 years met inclusion criteria. Children had higher mean ± standard deviation time in range (3.9-10.0 mmol/L) during school (58.0% ± 15.8%) than equivalent hours during school holidays (53.5% ± 18.8%, p < 0.001) and weekends (56.6% ± 17.3%, p = 0.006). Children had lower mean sensor glucose, SD sensor glucose and time above range (> 10.0 and > 13.9 mmol/L) during school compared to school holidays and weekends. Time below 3.9 mmol/L was higher during school time compared with weekdays during school holidays (p = 0.024), but lower than on school term weekends (p = 0.009), and < 4% in all periods. There was no significant difference in time below 3.0 mmol/L.

CONCLUSIONS: Primary school-aged children in WA had modestly improved glycaemia during school compared with weekends, with more pronounced improvements compared with school holidays.

PMID:42249791 | DOI:10.1111/jpc.70463

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