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Psychological Stressors during Childhood Associated with Higher Risk for T1

SLE (Stressful Life Events) experienced by child during first 14 years of life associated with higher risk of diabetes…

Genetic and environmental factors are involved in the development of type 1 diabetes. Multiple environmental factors have been studied, such as viral infections, dietary habits in infancy, birthweight, early weight gain, and chronic stress. This study was the first retrospective study of individuals, in which researchers examined whether psychological stress during childhood, parental perception of parenting stress, and lack of social support during the first 14 years of life could contribute to the development of type 1 diabetes.

All babies born between October 1st, 1997 and September 30th, 1999 were invited by the All Babies In Southeast Sweden (ABIS) study to participate. A total of 10,495 children in 250 clinics were enrolled in the study after participating in one of four data collections during the first 14 years of life, which were at age 1, 2-3, 5-6, 8 and 10-13 years. Of these, 58 out of 10,495 children were diagnosed with type 1 diabetes. Inclusion criteria included children who had not been diagnosed with diabetes. Exclusion criteria included children with a missing date of participation. The questionnaire was filled out either in clinics or at home, then was returned by mail. No reminders were used except for the questionnaire at 10-13 years. Various exposure variables were assessed, including psychological stress, experiences of stressful life events (SLE), parenting stress and worries, and parent’s social support. Cox regression was used for statistical analysis.

After adjusting for heredity of type 1 diabetes and age at entry, it was shown that childhood psychological stressors such as serious life events increased the risk of type 1 diabetes (HR 3.0 [95% CI 1.6, 5.6), p=0.001). Parent’s perception of parenting stress and parental worries or social support were not found to be associated with the development of type 1 diabetes. The results remained the same when adjusting for heredity of type 2 diabetes, size for gestational age, educational level of the parents, and the mother’s work status before the child’s birth (HR 2.8 [95% CI 1.5, 5.4[, p=0.002). The same association was found when childhood BMI was used in the model (HR 5.0 [95% CI 2.3, 10.7], p <0.001).

In this population-based prospective study, an SLE experienced by the child during the first 14 years of life was associated with 3 times higher risk of type 1 diabetes independent of heredity, heredity for type 2 diabetes, size of gestational age, educational level of the parents, the mother’s work status before the child’s birth, and the childhood BMI. Parent’s perception of parenting stress and parental worries or social support were not found to be associated with the development of type 1 diabetes. However, heredity is still a stronger risk factor for the development of type 1 diabetes compared to the psychological stress.

Practice Pearls:

  • An SLE experienced by the child during the first 14 years of life was associated with 3 times higher risk of type 1 diabetes.
  • Parent’s perception of parenting stress and parental worries or social support were not found to be associated with the development of type 1 diabetes.
  • Heredity is still a stronger risk factor or the development of type 1 diabetes compared to the psychological stress.

Nygren et al. “Experience of a serious life event increases the risk for childhood type 1 diabetes: the ABIS population-based prospective cohort study.” Diabelogia. DOI 10.1007/s00125-015-3555-2.