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Family Characteristics and Life Events Before the Onset of Autoimmune Type 1 Diabetes in Young Adults

A nationwide study

¹ Community Health Sciences
² Endocrinology, Malmö University Hospital, Malmö
³ Epidemiology Department of Public Health and Clinical Medicine, Umeå University
⁴ Department of Medicine, University Hospital, Umeå
⁵ Diabetes Education and Research Center (DERC), Karolinska Hospital, Stockholm
⁶ Department of Internal Medicine, Huddinge Hospital, Huddinge
⁷ Department of Internal Medicine, University Hospital of Lund, Lund
⁸ Department of Internal Medicine, Faculty of Health Sciences, University of Linköping, Linköping
⁹ Department of Internal Medicine, Sahlgrenska University Hospital, University of Göteborg, Göteborg
¹⁰ Department of Medicine, University Hospital, Uppsala, Sweden

OBJECTIVE—To elucidate whether family characteristics and stressful life events were associated with onset of autoimmune type 1 diabetes in young adults.

RESEARCH DESIGN AND METHODS—This investigation was based on a nationwide study (Diabetes Incidence Study in Sweden) of newly diagnosed patients aged 15–34 years. Patients clinically classified as type 1 diabetic with antibodies to islet cells and/or to GAD65 were compared with age- and sex-matched control subjects via questionnaire. The questionnaire covered diabetes heredity, social environment, educational level, and life events experienced during the 12 months before diagnosis.

RESULTS—The rate of response was 82% for the diabetic patients and 65% for the control subjects. Questionnaires from 349 diabetic patients and 979 control subjects were considered. Diabetes in relatives was more frequent in the patients (odds ratio [OR]2.6) who were born in Sweden and whose mothers were of Swedish origin. No major stress factors were detected in the diabetic patients; however, in comparison with the control subjects, the diabetic patients had experienced fewer conflicts with their parents and had less often broken contacts with friends.

CONCLUSIONS—Young adults with recent-onset type 1 diabetes were more exposed to heredity for diabetes, but no major prediabetic stress factors were detected. Our study does not directly support the concept that psychosocial stressful life events are involved in the development of autoimmune type 1 diabetes in young adults.

Abbreviations: DISS, Diabetes Incidence Study in Sweden • GADA, GAD antibodies • ICA, islet cell antibodies • JDF, Juvenile Diabetes Foundation • LES, Life Event Scale • OR, odds ratio • W/H, waist-to-hip

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