Psychologically stressful events, such as family break-up, death or illness, in childhood increase the risk of a future diagnosis of type 1 diabetes, according to a new study from Linköping University in Sweden.
While previous studies showing an association between stressful life events and type 1 diabetes risk have been retrospective and, thus, subject to recall bias, the ABIS (All Babies In Southeast Sweden) study is the first prospective study to show such a link. According to Maria Nygren, a PhD student at Linköping University and the corresponding author of the study, the results “give us strong reason to believe that psychological stress can play a part somewhere in the immunological process leading to the onset of type 1 diabetes.”
In ABIS, a total of 10 495 children born between 1997 and 1999 were recruited, of whom 58 were diagnosed with diabetes during the follow-up. After adjustment for family history of diabetes and age at study entry, experience of a serious life event was associated with a higher risk of future type 1 diabetes diagnosis (hazard ratio, 3.0; 95% confidence interval, 1.6–5.6).
While heredity is still the greatest single risk factor for developing the condition, with a hazard ratio of 12.2 in this study, the authors state that stressful life events make up another piece of the puzzle, conferring a risk comparable to other environmental factors such as birth weight, infant nutrition and enterovirus infection.
The authors suggest a number of possible mechanisms by which stressful events could be linked to type 1 diabetes, including elevated cortisol levels promoting insulin resistance and long-term stress promoting immune responses against the pancreatic beta-cells.
Ms Nygren said that, while these findings had no direct clinical implications, they were “a reminder of the importance to give support to children who have experienced traumatic life events, not only for mental health reasons, but also to reduce risk of disease.”
The study can be read in full here.
