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10 April 2015, 04:00
Stressful life events in childhood such as death or illness in the family, divorce or separation, can triple the risk of developing type 1 diabetes, research has suggested.
A study carried out in Sweden analysed more than 10,000 families with children aged between two and 14 who did not already have the condition and also looked at factors including whether there was any family conflict, change of family structure, interventions from social services or unemployment.
Parents were given questionnaires asking them to assess such serious life events, parental stress, worries and the parent's social support and 58 children were subsequently diagnosed with type 1 diabetes.
Researchers said that as it is unlikely such stressful events can be avoided, families need support to cope if such problems occur.
The study said that while the causes of type 1 diabetes are unknown, it is usually preceded by the body's own immune system attacking and killing beta cells in the pancreas, which produce insulin.
Environmental factors such as viral infection, dietary habits, birth weight and early weight gain, as well as chronic stress, have all been proposed as risk factors, and the new research aimed to examine whether psychological stress during a child's first 14 years of life might increase the risk.
They said that since rates among young children are increasing in most countries, environmental factors are being examined even more seriously.
Genetic predisposition remains the most important factor, with a 12-fold increase in the risk of developing type 1 diabetes for a child from a family in which another close family member has it.
The study authors suggested that stressful events during childhood could contribute to beta cell stress due to increased insulin resistance, as well as increased insulin demands due to the physiological stress response, such as elevated levels of the stress hormone cortisol.
They concluded: "Consistent with several previous retrospective studies, this first prospective study concludes that the experience of a serious life event (reasonably indicating psychological stress) during the first 14 years of life may be a risk factor for developing type 1 diabetes.
"The current study examined serious life events experienced at any time before diagnosis; further studies are thus needed to determine when in the autoimmune process psychological stress may contribute, and in association with which other factors such as genetic factors, infections or other periods of pronounced beta cell stress.''
The study, carried out at Linkoping University, is published in Diabetologia (the journal of the European Association for the Study of Diabetes).
The majority of people have type 2 diabetes, which is associated with being overweight, but more than 95% of cases of diabetes in children are type 1 and rates have been increasing in recent years.