Relationship Between Hypoglycemia Frequency and Academic Performance in Children With Type 1 Diabetes

Background: Type 1 diabetes mellitus (T1DM) in children necessitates intensive insulin therapy, which predisposes patients to recurrent hypoglycemic episodes. Objective: To evaluate the association between the frequency of hypoglycemic episodes and academic performance among children with type 1 diabetes by correlating glycemic patterns with scholastic outcomes. Methods: This cross-sectional analytical study was conducted at Children Hospital Lahore from March 2024 to March 2025 and included 275 children diagnosed with T1DM. Data regarding hypoglycemic episodes, glycemic control, academic scores, and school attendance were collected and analyzed. Results: The mean age of participants was 11.8 ± 2.9 years, with a mean glycated hemoglobin (HbA1c) of 8.7 ± 1.4%. The average frequency of hypoglycemic episodes was 5.8 ± 3.4 per month. High-frequency hypoglycemia was observed in 29.1% of children, while 25.8% reported severe episodes. The mean academic score was 74.6 ± 10.8%, and average attendance was 88.5 ± 7.6%. A significant decline in academic performance was noted with increasing hypoglycemia frequency; children in the high-frequency group had lower academic scores (65.8 ± 9.7% vs 82.1 ± 7.6%), reduced attendance (81.7 ± 7.8% vs 93.4 ± 4.2%), and higher absenteeism (21.4 ± 6.2 vs 8.7 ± 3.5 days/year) (p < 0.001). A strong negative correlation was observed between hypoglycemia frequency and academic scores (r = −0.62). Conclusion: Recurrent hypoglycemia is significantly associated with poorer academic performance and increased absenteeism among children with type 1 diabetes, highlighting the importance of optimizing glycemic control to improve both clinical and educational outcomes.