Bereavement and type 1 diabetes in childhood: a register-based cohort study in Sweden

TL;DR

This study found no link between childhood bereavement and the development of type 1 diabetes in Sweden.

Contribution

It is the first large-scale population study to investigate the association between childhood bereavement and type 1 diabetes.

Findings

No overall association was found between childhood bereavement and type 1 diabetes diagnosis.

Adjusting for confounders did not change the lack of association.

Bereavement characteristics like age at loss or cause of death had no influence on diabetes risk.

Abstract

The potential impact of childhood bereavement—a severe psychological stressor—on childhood type 1 diabetes development remains unclear. Here, we aimed to bridge this knowledge gap and assess whether bereavement characteristics influenced any impact.

We conducted a register-based cohort study encompassing 3,598,159 children born in Sweden between 1987 and 2020. Childhood bereavement was defined as the death of a biological mother, father or sibling. Diagnosis of type 1 diabetes in childhood (<18 years) was ascertained through the National Patient Register. We applied a Cox proportional hazards regression model to investigate the impact of childhood bereavement on type 1 diabetes, while adjusting for potential confounders (including parental type 1 diabetes status, country of birth and demographic characteristics).

During follow-up, 86,226 children (2.4%) lost a family member, and 18,817 children (0.52%) were diagnosed with type 1 diabetes (median age at onset 9.1 years). We did not detect any overall association between childhood bereavement and type 1 diabetes (adjusted HR 1.04; 95% CI 0.93, 1.17). We found no influence of age at loss, cause of death, familial relationship to the deceased, and time since loss.

In this large population-based Swedish study, we observed no evidence supporting a link between childhood bereavement and type 1 diabetes.

The online version contains peer-reviewed but unedited supplementary material available at 10.1007/s00125-024-06340-z.

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