P-39: Parental educational level and long-term glycaemic control in pediatric type 1 diabetes: national registry data from Sweden
K Åkesson, J Hagen, J LudvigssonAbstract
Introduction
Socioeconomic disparities in glycemic control have been reported in pediatric type 1 diabetes (T1D), but long-term patterns according to parental educational level remain incompletely characterized.
Objectives
To describe long-term trajectories of glycemic control in children with T1D according to maternal and paternal educational level at diagnosis.
Methods
This nationwide register-based study used data from the Swedish National Diabetes Register, including children diagnosed with T1D in Sweden before 18 years of age 1996 to 2023 (n ≈ 24,000). Mean HbA1c values were calculated for each year since diagnosis and followed for up to 20 years. Children were grouped according to maternal and paternal educational level at diagnosis: pre-secondary, secondary, or post-secondary education. Parental socioeconomic data were obtained from the Longitudinal Integration Database for Health Insurance and Labour Market Studies and linked to the child through the Swedish Multi-Generation Register.
Results
Persistent educational gradients in HbA1c were observed for both maternal and paternal education. Across all years since diagnosis, children of parents with presecondary education had the highest mean HbA1c, whereas children of parents with post-secondary education (≥12 years) consistently had the lowest. The difference peaked at approximately 8 mmol/mol 2 years after diagnosis and thereafter remained between 5 and 6 mmol/mol at 5, 10 and 15 years after diagnosis. The overall decline in HbA1c over calendar time reflects improvements in diabetes care.
Conclusions
Sustained differences in long-term glycemic control are evident according to both maternal and paternal educational level. These descriptive findings demonstrate early and persistent socioeconomic gradients in glycemic outcomes and suggest that families with lower parental education may require additional support within pediatric diabetes care.