Stressful Life Events and Psychological Dysfunctions Before the Onset of Type 1 Diabetes Mellitus

Šipetić, Sandra; Vlajinac, Hristina; Marinkovi, Jelena; Kocev, Nikola; Milan, Bjekic; Ratkov, Isidora; Sajic, Silvija

doi:10.1515/jpem.2007.20.4.527

Cited by 27 publications

(28 citation statements)

References 31 publications

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“…Comparison with other studies Our prospective study confirms the findings from several retrospective studies that observed an association between type 1 diabetes and previous experiences of SLEs [7][8][9][10][11][12][13][14][15][16][17]. Some previous studies found an association with stressful life events in general [9,10,[14][15][16], while other studies were more limited to specific events [7,8,13,17], events judged as negative for the child [12] or specific events in a specific age group [11].…”

Section: Strengths and Limitations Of The Studysupporting

confidence: 89%

“…Some previous studies found an association with stressful life events in general [9,10,[14][15][16], while other studies were more limited to specific events [7,8,13,17], events judged as negative for the child [12] or specific events in a specific age group [11]. However, previous retrospective studies have the methodological shortcoming of recall bias, which has been, for the first time on an individual level, avoided in the current study.…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 70%

“…In the current study, exposure to psychological stress could have occurred at any time in childhood before diagnosis; in contrast, the majority of the previous retrospective studies investigated exposure in the year(s) shortly before onset [9][10][11][12][13][14][15][16][17]. Earlier exposure has been investigated, but with inconsistent results [7,8,10,12,16].…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 92%

“…Some previous studies have found an association between diabetes and the experience of one or more severe life events for the child before diagnosis [9,10,[14][15][16], but other studies have only found such an association for specific types of life events [11,13,17], or only if the event had been judged as negative for the child [12]. More chaotic family function, but not a lack of parental social support, has been associated with a diagnosis [12].…”

Section: Introductionmentioning

confidence: 99%

“…In particular, severe life events during childhood have been studied as a potential risk factor for type 1 diabetes, mainly retrospectively [7][8][9][10][11][12][13][14][15][16]. One study examined stress exposure on a group level [17] and one prospective study examined stress early in life [18].…”

Section: Introductionmentioning

confidence: 99%

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Experience of a serious life event increases the risk for childhood type 1 diabetes: the ABIS population-based prospective cohort study

et al. 2015

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Aims/hypothesis The aim of this study was to prospectively investigate whether psychological stress during childhood may be a risk factor for manifest type 1 diabetes. Methods The All Babies In Southeast Sweden (ABIS) study invited all families with babies born between 1 October 1997 and 30 September 1999 in southeast Sweden to participate. Our study subsample includes 10,495 participants in at least one of the data collections at 2-3, 5-6, 8 and 10-13 years of age not yet diagnosed with type 1 diabetes at inclusion; 58 children were subsequently diagnosed. Age at diagnosis was obtained from the national register SweDiabKids in 2012. Family psychological stress was measured via questionnaires given to the parents assessing serious life events, parenting stress, parental worries and the parent's social support. Results Childhood experience of a serious life event was associated with a higher risk of future diagnosis of type 1 diabetes (HR 3.0 [95% CI 1.6, 5.6], p=0.001) after adjusting for heredity of type 1 diabetes and age at entry into the study. The result was still valid when controlling for heredity of type 2 diabetes, size for gestational age, the parents' education level and whether the mother worked at least 50% of full time before the child's birth (HR 2.8 [95% CI 1.5, 5.4], p = 0.002), and also when childhood BMI was added to the model (HR 5.0 [95% CI 2.3, 10.7], p<0.001). Conclusions/interpretation This first prospective study concluded that experience of a serious life event in childhood may be a risk factor for manifest type 1 diabetes.

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Section: Strengths and Limitations Of The Studysupporting

confidence: 89%

Section: Strengths and Limitations Of The Studymentioning

confidence: 70%

Section: Strengths and Limitations Of The Studymentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Experience of a serious life event increases the risk for childhood type 1 diabetes: the ABIS population-based prospective cohort study

et al. 2015

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Type 1 diabetes: can exercise impair the autoimmune event? TheL‐arginine/glutamine coupling hypothesis

Krause

Bittencourt

2008

Cell Biochemistry & Function

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Prevention of type 1 diabetes mellitus (T1DM) requires early intervention in the autoimmune process directed against beta-cells of the pancreatic islets of Langerhans, which is believed to result from a disorder of immunoregulation. According to this concept, a T-helper lymphocyte of type 1 (Th1) subset of T-lymphocytes and their cytokine products, the type 1 cytokines [e.g. interleukin 2 (IL-2), interferon gamma (IFN-gamma) and tumour necrosis factor beta (TNF-beta)] prevail over immunoregulatory (anti-inflammatory) Th2 subset and its cytokine products, i.e. type 2 cytokines (e.g. IL-4, IL-6 and IL-10). This allows type 1 cytokines to initiate a cascade of immune/inflammatory processes in the islet (insulitis), culminating in beta-cell destruction. Activation of sympathetic-corticotropin-releasing hormone (CRH) axis by psychological stress induces specifically Th1 cell overactivity that determines enhanced glutamine utilization and consequent poor L-arginine supply for nitric oxide (NO)-assisted insulin secretion. This determines the shift of intraislet glutamate metabolism from the synthesis of glutathione (GSH) to that of L-arginine, leading to a redox imbalance that activates nuclear factor kappaB exacerbating inflammation and NO-mediated cytotoxicity. Physical exercise is capable of inducing changes in the pattern of cytokine production and release towards type 2 class and to normalize the glutamine supply to the circulation, which reduces the need for glutamate, whose metabolic fate may be restored in the direction of GSH synthesis and antioxidant defence. Also, the 70-kDa heat shock protein (hsp70), which is immunoregulatory, may modulate exercise-induced anti-inflammation. In this work, we envisage how exercise can intervene in the mechanisms involved in the autoimmune process against beta-cells and how novel therapeutic approaches may be inferred from these observations.

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

Wernroth,

Kennedy,

Fall

et al. 2024

Diabetologia

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Aims/hypothesis 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. Methods 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). Results 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. Conclusions/interpretation In this large population-based Swedish study, we observed no evidence supporting a link between childhood bereavement and type 1 diabetes. Graphical Abstract

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Stressful Life Events and Psychological Dysfunctions Before the Onset of Type 1 Diabetes Mellitus

Abstract: These results support the hypothesis that stressful life events and psychological dysfunctions are associated with DM1.

Cited by 27 publications

References 31 publications

Experience of a serious life event increases the risk for childhood type 1 diabetes: the ABIS population-based prospective cohort study

Experience of a serious life event increases the risk for childhood type 1 diabetes: the ABIS population-based prospective cohort study

Type 1 diabetes: can exercise impair the autoimmune event? TheL‐arginine/glutamine coupling hypothesis

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

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