# 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.

## Key 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.