SYSTEMATIC REVIEW article
Front. Public Health
Sec. Life-Course Epidemiology and Social Inequalities in Health
This article is part of the Research TopicPerceptions of Diabetes Across LifespanView all 7 articles
Navigating Adulthood with Juvenile-Onset Type 1 Diabetes: a Scoping Review on Education, Employment and Quality of Life
Provisionally accepted
Eleonora Maurel1
Arianna Fornari2*
Alessandra Knowles1*
Erika Guastafierro2
Martina Lanza2Alessia Marcassoli2
Matilde Leonardi2
Luca Ronfani1
Lorenzo Monasta1- 1IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy
- 2Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Background: Juvenile type 1 diabetes can present lifelong challenges that may affect educational, employment, and health-related quality of life (HRQoL) outcomes in adulthood. This scoping review aims at exploring the long-term impact of juvenile-onset type 1 diabetes on education and career achievements and well-being in adulthood. Methods: A scoping review conducted using PubMed and PsycInfo (2005–2025) identified studies comparing adults diagnosed with type 1 diabetes during childhood and adolescence to controls without type 1 diabetes. Three studies focusing on educational attainment, employment, income, and HRQoL, met the inclusion criteria. Results: The studies included in the review show that university attendance is significantly lower among individuals with juvenile-onset type 1 diabetes, and this affects both men and women. Access to the labour market and earnings are similarly affected, especially in the case of women who experience both lower employment rates and income, compared to controls without diabetes. Men with type 1 diabetes have equal opportunities for workforce entry, but this does not translate into long-term income parity. Compared to healthy controls, HRQoL is lower among adults with type 1 diabetes, particularly in the school/work and emotional domains. Common challenges include low energy, forgetfulness, and concentration difficulties. Conclusions: While it is a matter of debate how juvenile-onset type 1 diabetes affects academic achievements, there is general agreement that it leads to persistent disadvantages in employment and HRQoL in adulthood. Targeted support from diagnosis and during transition to adulthood is essential to mitigate the long-term impact of juvenile-onset type 1 diabetes on educational, employment and psychosocial outcomes for this population.
Keywords: Diabetes, type 1, Achievement, educational, Employment, health-related quality of life, Mental Health
Received: 17 Sep 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Maurel, Fornari, Knowles, Guastafierro, Lanza, Marcassoli, Leonardi, Ronfani and Monasta. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Arianna Fornari
Alessandra Knowles
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.