Stressful Life Events in Childhood and Development of Type 1 Diabetes

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Risk for type 1 diabetes increased for children whose parents reported unemployment, conflict in the family, or divorce during the first 2 years of life.
Risk for type 1 diabetes increased for children whose parents reported unemployment, conflict in the family, or divorce during the first 2 years of life.

Children whose parents experienced a severe life event during the first 2 years of the child's life may be at an increased risk for type 1 diabetes (T1D) developing later in life, according to a study published in Acta Diabetologica. 

Researchers conducted a prospective study, recruiting children born between August 2000 and September 2004 in southern Sweden. Parents of children born during the selected time frame who met inclusion criteria were asked to complete a survey when their child was 2 months of age to assess the perinatal, hereditary, medical, social factors, and occurrences of severe life events during pregnancy or the first 2 months of the child's life.

Severe life events of high intensity included the death of a close relative, serious accident in the family, and experiences of violence; those of low intensity included divorce in the family, unemployment of either parent, or the divorce of the parents.

Parents were again surveyed for the occurrences of severe life events when the child reached 2 years of age. A total of 23,187 and 3784 surveys were returned by parents of children at 2 months and 2 years of age, respectively. The purpose of the study was to determine whether the occurrence of severe life events reported by parents during the first 2 years of a child's life influenced the child's risk for T1D developing later. The study also assessed whether compared with children who had a lower genetic risk for T1D, children with the highest human leukocyte antigen-conferred risk (HLA D2/8) were more susceptible to stress.

Study results found a significant increase in the risk for T1D developing in children whose parents reported a severe life event occurrence during their first 2 years of the child's life for both the total cohort and for the HLA-DQ2/8 high risk-population cohort (multiple regression hazard ratio (HR) 1.67; 95% CI, 1.1-2.7; P =.03 and HR 2.2; 95% CI, 1.1-4.2; P =.018, respectively).

Children whose parents reported unemployment/conflict in the family or divorce during the first 2 years of the child's life were at an increased risk for T1D developing; however, no increased risk for T1D was observed in children whose parents experienced a severe life event during pregnancy (multiple regression HR 2.07; 95% CI, 1.01-4.2; P =.047 and HR 1.27; 95% CI, 0.85-1.9; P =.24, respectively).

Interestingly, results from the subgroup analysis of the DQ2/8 cohort found an increased HR for T1D in children whose parents reported unemployment/conflict in the family or divorce during pregnancy or during the first 2 years of the child's life (HR 2.16; 95% CI, 1.1-4.3; P =.03 and HR 4.98; 2.3-11; P <.001).

Researchers concluded that while there was an assessed increase in risk for T1D in children whose parents reported a severe life event during the first 2 years of the child's life in both the entire cohort of children and in individuals identified as having the high-risk HLA DQ2/8 haplotype, the statistical analysis was weak because of the low number of serious life events in the cohort, and only 11% of parents of children initially screened completed the 2-year questionnaire. As a result, clinicians should interpret these data with care.

Reference

Lundgren M, Ellstrom K, Larsson HE. Influence of early-life parenteral severe life events on the risk of type 1 diabetes in children: the DipiS study [published online May 12, 2018]. Acta Diabetol. doi: 10.1007/s00592-018-1150-y

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