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Dahlquist, Gisela
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Publications (10 of 105) Show all publications
Waernbaum, I., Lind, T., Möllsten, A. & Dahlquist, G. (2023). The incidence of childhood-onset type 1 diabetes, time trends and association with the population composition in sweden: a 40 year follow-up. Diabetologia, 66(2), 346-353
Open this publication in new window or tab >>The incidence of childhood-onset type 1 diabetes, time trends and association with the population composition in sweden: a 40 year follow-up
2023 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 66, no 2, p. 346-353Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis: During the 1980s and 1990s, the incidence of childhood-onset type 1 diabetes more than doubled in Sweden, followed by a plateau. In the present 40 year follow-up, we investigated if the incidence remained stable and whether this could be explained by increased migration from countries reporting lower incidences.

Methods: We used 23,143 incident cases of childhood-onset type 1 diabetes reported between 1978 and 2019 to the nationwide, population-based Swedish Childhood Diabetes Registry and population data from Statistics Sweden. Generalised additive models and ANOVA were applied to analyse the effects of onset age, sex, time trends and parental country of birth and interaction effects between these factors.

Results: The flattening of the incidence increase seems to remain over the period 2005–2019. When comparing the incidence of type 1 diabetes for all children in Sweden with that for children with both parents born in Sweden, the trends were parallel but at a higher level for the latter. A comparison of the incidence trends between individuals with Swedish backgrounds (high diabetes trait) and Asian backgrounds (low diabetes trait) showed that the Asian subpopulation had a stable increase in incidence over time.

Conclusions/interpretation: In Sweden, the increase in incidence of childhood-onset type 1 diabetes in the late 20th century has been approaching a more stable albeit high level over the last two decades. Increased immigration from countries with lower incidences of childhood-onset type 1 diabetes does not provide a complete explanation for the observed levelling off. Graphical abstract: [Figure not available: see fulltext.]

Place, publisher, year, edition, pages
Springer-Verlag New York, 2023
Keywords
Children, Immigration, Incidence, Time trend, Type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-200671 (URN)10.1007/s00125-022-05816-0 (DOI)000870664000001 ()36264296 (PubMedID)2-s2.0-85140249104 (Scopus ID)
Funder
Swedish Research Council, 2018-02565Swedish Research Council, 2016-00703
Available from: 2022-11-07 Created: 2022-11-07 Last updated: 2023-01-11Bibliographically approved
Fredriksson, M., Persson, E., Dahlquist, G., Möllsten, A. & Lind, T. (2022). Risk of cancer in young and middle-aged adults with childhood-onset type 1 diabetes in Sweden - A prospective cohort study. Diabetic Medicine, Article ID e14771.
Open this publication in new window or tab >>Risk of cancer in young and middle-aged adults with childhood-onset type 1 diabetes in Sweden - A prospective cohort study
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2022 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, article id e14771Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis: In persons with type 1 diabetes, the risk of cancer remains controversial. We wanted to examine the excess risk of cancer in a large population-based cohort diagnosed with type 1 diabetes before 15 years of age.

Study population and methods: From 1 July 1977 to 31 December 2013, we prospectively and on a national scale included 18,724 persons (53% men) with childhood-onset type 1 diabetes. For each person with type 1 diabetes, we selected four referents, matched for the date at birth and municipality of living at the time when the case developed diabetes. Cases and referents were linked to national registers of cancer and of the cause of death.

Results: A total of 125 persons (61% women) with diabetes had 135 different cancers, all diagnosed after the diabetes diagnosis. The median duration from diabetes diagnosis to first cancer diagnosis was 19 years (interquartile range 10-26). The median age at cancer diagnosis in the diabetes group was 28 years (interquartile range 20-35). The overall standardized incidence ratio (95%), using the Swedish general population as referents for women with diabetes was 1.28 (1.02, 1.58) and when comparing women with diabetes with matched referents, we found a hazard ratio of 1.42 (1.10, 1.85). No elevated risk was seen for men. Cancers of the breast and testis were the most common types in women and men respectively.

Conclusions: Women with childhood-onset type 1 diabetes had a small but significantly elevated risk of cancer. No such tendency was seen for men. The reason behind this is unclear.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-190979 (URN)10.1111/dme.14771 (DOI)000734276400001 ()34923678 (PubMedID)2-s2.0-85121793257 (Scopus ID)
Funder
Region VästerbottenSwedish Research Council, 2018‐02565
Available from: 2022-01-04 Created: 2022-01-04 Last updated: 2022-07-19Bibliographically approved
Toppe, C., Möllsten, A., Waernbaum, I., Schön, S., Gudbjörnsdottir, S., Landin-Olsson, M. & Dahlquist, G. (2019). Decreasing Cumulative Incidence of End-Stage Renal Disease in Young Patients With Type 1 Diabetes in Sweden: a 38-Year Prospective Nationwide Study. Diabetes Care, 42(1), 27-31
Open this publication in new window or tab >>Decreasing Cumulative Incidence of End-Stage Renal Disease in Young Patients With Type 1 Diabetes in Sweden: a 38-Year Prospective Nationwide Study
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2019 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 42, no 1, p. 27-31Article in journal (Refereed) Published
Abstract [en]

Objective: Diabetic nephropathy is a serious complication of type 1 diabetes. Recent studies indicate that end-stage renal disease (ESRD) incidence has decreased or that the onset of ESRD has been postponed; therefore, we wanted to analyze the incidence and time trends of ESRD in Sweden.

Research design and methods: In this study, patients with duration of type 1 diabetes >14 years and age at onset of diabetes 0–34 years were included. Three national diabetes registers were used: the Swedish Childhood Diabetes Register, the Diabetes Incidence Study in Sweden, and the National Diabetes Register. The Swedish Renal Registry, a national register on renal replacement therapy, was used to identify patients who developed ESRD.

Results: We found that the cumulative incidence of ESRD in Sweden was low after up to 38 years of diabetes duration (5.6%). The incidence of ESRD was lower in patients with type 1 diabetes onset in 1991–2001 compared to onset in 1977–1984 and 1985–1990, independently of diabetes duration.

Conclusion: The risk of developing ESRD in Sweden in this population is still low and also seems to decrease with time.

Place, publisher, year, edition, pages
American Diabetes Association, 2019
National Category
Pediatrics Urology and Nephrology
Identifiers
urn:nbn:se:umu:diva-153168 (URN)10.2337/dc18-1276 (DOI)000453904900014 ()30352897 (PubMedID)2-s2.0-85059071263 (Scopus ID)
Funder
Swedish Research Council, 0753Västerbotten County Council
Available from: 2018-11-08 Created: 2018-11-08 Last updated: 2023-03-24Bibliographically approved
Waernbaum, I., Dahlquist, G. & Lind, T. (2019). Perinatal risk factors for type 1 diabetes revisited: a population-based register study. Diabetologia, 62(7), 1173-1184
Open this publication in new window or tab >>Perinatal risk factors for type 1 diabetes revisited: a population-based register study
2019 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 62, no 7, p. 1173-1184Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis: Single-centre studies and meta-analyses have found diverging results as to which early life factors affect the risk of type 1 diabetes during childhood. We wanted to use a large, nationwide, prospective database to further clarify and analyse the associations between perinatal factors and the subsequent risk for childhood-onset type 1 diabetes using a case–control design.

Methods: The Swedish Childhood Diabetes Register was linked to the Swedish Medical Birth Register and National Patient Register, and 14,949 cases with type 1 diabetes onset at ages 0–14 years were compared with 55,712 matched controls born from the start of the Medical Birth Register in 1973 to 2013. After excluding confounders (i.e. children multiple births, those whose mother had maternal diabetes and those with a non-Nordic mother), we used conditional logistic regression analyses to determine risk factors for childhood-onset type 1 diabetes. We used WHO ICD codes for child and maternal diagnoses.

Results: In multivariate analysis, there were small but statistically significant associations between higher birthweight z score (OR 1.08, 95% CI 1.06, 1.10), delivery by Caesarean section (OR 1.08, 95% CI 1.02, 1.15), premature rupture of membranes (OR 1.08, 95% CI 1.01, 1.16) and maternal urinary tract infection during pregnancy (OR 1.39, 95% CI 1.04, 1.86) and the subsequent risk of childhood-onset type 1 diabetes. Birth before 32 weeks of gestation was associated with a lower risk of childhood-onset type 1 diabetes compared with full-term infants (OR 0.54, 95% CI 0.38, 0.76), whereas birth between 32 and 36 weeks’ gestation was associated with a higher risk (OR 1.24, 95% CI 1.14, 1.35). In subgroup analyses (birth years 1992–2013), maternal obesity was independently associated with subsequent type 1 diabetes in the children (OR 1.27, 95% CI 1.15, 1.41) and rendered the association with Caesarean section non-significant. In contrast to previous studies, we found no association of childhood-onset type 1 diabetes with maternal–child blood-group incompatibility, maternal pre-eclampsia, perinatal infections or treatment of the newborn with phototherapy for neonatal jaundice. The proportion of children with neonatal jaundice was significantly higher in the 1973–1982 birth cohort compared with later cohorts.

Conclusions/interpretation: Perinatal factors make small but statistically significant contributions to the overall risk of childhood-onset type 1 diabetes. Some of these risk factors, such as maternal obesity, may be amendable with improved antenatal care. Better perinatal practices may have affected some previously noted risk factors over time.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Birthweight, Case-control study, Diabetes mellitus type 1, Perinatal risk factors, Urinary tract infection
National Category
Endocrinology and Diabetes Pediatrics
Identifiers
urn:nbn:se:umu:diva-161440 (URN)10.1007/s00125-019-4874-5 (DOI)000471176200008 ()31041471 (PubMedID)2-s2.0-85065230302 (Scopus ID)
Funder
Swedish Research Council, 2016-00703Swedish Research Council, 2014-07531
Available from: 2019-07-10 Created: 2019-07-10 Last updated: 2023-03-24Bibliographically approved
Patterson, C. C., Harjutsalo, V., Rosenbauer, J., Neu, A., Cinek, O., Skrivarhaug, T., . . . Green, A. (2019). Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25year period 1989-2013: a multicentre prospective registration study. Diabetologia, 62(3), 408-417
Open this publication in new window or tab >>Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25year period 1989-2013: a multicentre prospective registration study
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2019 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 62, no 3, p. 408-417Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis: Against a background of a near-universally increasing incidence of childhood type 1 diabetes, recent reports from some countries suggest a slowing in this increase. Occasional reports also describe cyclical variations in incidence, with periodicities of between 4 and 6years.

Methods: Age/sex-standardised incidence rates for the 0- to 14-year-old age group are reported for 26 European centres (representing 22 countries) that have registered newly diagnosed individuals in geographically defined regions for up to 25years during the period 1989-2013. Poisson regression was used to estimate rates of increase and test for cyclical patterns. Joinpoint regression software was used to fit segmented log-linear relationships to incidence trends.

Results: Significant increases in incidence were noted in all but two small centres, with a maximum rate of increase of 6.6% per annum in a Polish centre. Several centres in high-incidence countries showed reducing rates of increase in more recent years. Despite this, a pooled analysis across all centres revealed a 3.4% (95% CI 2.8%, 3.9%) per annum increase in incidence rate, although there was some suggestion of a reduced rate of increase in the 2004-2008 period. Rates of increase were similar in boys and girls in the 0- to 4-year-old age group (3.7% and 3.7% per annum, respectively) and in the 5- to 9-year-old age group (3.4% and 3.7% per annum, respectively), but were higher in boys than girls in the 10- to 14-year-old age group (3.3% and 2.6% per annum, respectively). Significant 4year periodicity was detected in four centres, with three centres showing that the most recent peak in fitted rates occurred in 2012.

Conclusions/interpretation: Despite reductions in the rate of increase in some high-risk countries, the pooled estimate across centres continues to show a 3.4% increase per annum in incidence rate, suggesting a doubling in incidence rate within approximately 20years in Europe. Although four centres showed support for a cyclical pattern of incidence with a 4year periodicity, no plausible explanation for this can be given.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Cyclical variation, Epidemiology, Incidence, Temporal change, Type 1 diabetes mellitus
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-156862 (URN)10.1007/s00125-018-4763-3 (DOI)000458634100007 ()30483858 (PubMedID)2-s2.0-85061422689 (Scopus ID)
Available from: 2019-03-13 Created: 2019-03-13 Last updated: 2023-03-24Bibliographically approved
Patterson, C. C., Karuranga, S., Salpea, P., Saeedi, P., Dahlquist, G., Soltesz, G. & Ogle, G. D. (2019). Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 157, Article ID 107842.
Open this publication in new window or tab >>Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Diabetes Atlas, 9th edition
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2019 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 157, article id 107842Article in journal (Refereed) Published
Abstract [en]

Aims: This article describes the methods, results and limitations of the International Diabetes Federation (IDF) Diabetes Atlas 9th edition estimates of worldwide numbers of cases of type 1 diabetes in children and adolescents.

Methods: Most information in the published literature is in the form of incidence rates derived from registers of newly-diagnosed cases. After systematic review of the published literature and recent conference abstracts, identified studies were quality graded. If no study was available, extrapolation was used to assign a country the rate from an adjacent country with similar characteristics. Estimates of incident cases were obtained by applying incidence rates to United Nations 2019 population estimates. Estimates of prevalent cases were derived from incidence rates after making allowance for higher mortality rates in less-developed countries.

Results: Incidence rates were available for 45% of countries (ranging from 6% in the sub-Saharan Africa region to 77% in the European region). Worldwide annual incidence estimates were 98,200 (128,900) new cases in the under 15 year (under 20 year) age-groups. Corresponding prevalence estimates were 600,900 (1,110,100) existing cases. Compared with estimates in earlier Atlas editions, numbers have increased in most IDF regions, reflecting incidence rate increases, but prevalence estimates have decreased in sub-Saharan Africa because allowance has been made for increased mortality in those with diabetes.

Conclusions: Worldwide estimates of numbers of children and adolescents with type 1 diabetes continue to increase.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Type 1 diabetes, Incidence, Prevalence, Mortality, Children, Adolescents
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-167038 (URN)10.1016/j.diabres.2019.107842 (DOI)000500935200031 ()31518658 (PubMedID)2-s2.0-85075730823 (Scopus ID)
Available from: 2020-01-09 Created: 2020-01-09 Last updated: 2023-03-23Bibliographically approved
Persson, S., Dahlquist, G., Gerdtham, U.-G. & Carlsson, K. S. (2018). Why childhood-onset type 1 diabetes impacts labour market outcomes: a mediation analysis. Diabetologia, 61(2), 342-353
Open this publication in new window or tab >>Why childhood-onset type 1 diabetes impacts labour market outcomes: a mediation analysis
2018 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 61, no 2, p. 342-353Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis: Previous studies show a negative effect of type 1 diabetes on labour market outcomes such as employment and earnings later in life. However, little is known about the mechanisms underlying these effects. This study aims to analyse the mediating role of adult health, education, occupation and family formation.

Methods: A total of 4179 individuals from the Swedish Childhood Diabetes Register and 16,983 individuals forming a population control group born between 1962 and 1979 were followed between 30 and 50 years of age. The total effect of having type 1 diabetes was broken down into a direct effect and an indirect (mediating) effect using statistical mediation analysis. We also analysed whether type 1 diabetes has different effects on labour market outcome between the sexes and across socioeconomic status.

Results: Childhood-onset type 1 diabetes had a negative impact on employment (OR 0.68 [95% CI 0.62, 0.76] and OR 0.76 [95% CI 0.67, 0.86]) and earnings (−6%, p < 0.001 and −8%, p < 0.001) for women and men, respectively. Each of the mediators studied contributed to the total effect with adult health and occupational field accounting for the largest part. However, some of the effect could not be attributed to any of the mediators studied and was therefore likely related to other characteristics of the disease that hamper career opportunities. The effect of type 1 diabetes on employment and earnings did not vary significantly according to socioeconomic status of the family (parental education and earnings).

Conclusions/interpretation: A large part of the effect of type 1 diabetes on the labour market is attributed to adult health but there are other important mediating factors that need to be considered to reduce this negative effect.

Keywords
Children, Education, Inpatient care, Mediation analysis, Occupation, Outpatient care, Sickness nefits, Type 1 diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-144082 (URN)10.1007/s00125-017-4472-3 (DOI)000419011600010 ()29170854 (PubMedID)2-s2.0-85034749583 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-0768Swedish Research Council, 2014–646
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2023-03-23Bibliographically approved
Toppe, C., Möllsten, A., Schon, S. & Dahlquist, G. (2017). Socio-economic factors influencing the development of end-stage renal disease in people with Type 1 diabetes: a longitudinal population study. Diabetic Medicine, 34(5), 676-682
Open this publication in new window or tab >>Socio-economic factors influencing the development of end-stage renal disease in people with Type 1 diabetes: a longitudinal population study
2017 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 34, no 5, p. 676-682Article in journal (Refereed) Published
Abstract [en]

Aims: The development of end-stage renal disease (ESRD) in Type 1 diabetes is multifactorial. Familial socio-economic factors may influence adherence to and understanding of diabetes treatment, and also general health behaviour. We investigate how parental and personal education level and exposure to low economic status, indicated by the need for income support, influence the development of ERSD caused by Type 1 diabetes.

Methods: Participants were retrieved from the nationwide Swedish Childhood Diabetes Registry, which was linked to the Swedish Renal Registry, to find people with ESRD caused by Type 1 diabetes, and to Statistic Sweden to retrieve longitudinal socio-economic data on participants and their parents. Data were analysed using Cox regression modelling.

Results: Of 9287 people with diabetes of duration longer than 14 years, 154 had developed ESRD due to diabetes. Median diabetes duration (range) for all participants was 24.2 years (14.0-36.7 years). Low maternal education ( 12 years) more than doubled the risk of developing ESRD, hazard ration (HR) = 2.9 [95% confidence interval (95% CI): 1.7-4.8]. For people with a low personal level of education HR was 5.7 (3.4-9.5). In an adjusted model, the person's own education level had the highest impact on the risk of ESRD. If at least one of the parents had ever received income support the HR was 2.6 (1.9-3.6).

Conclusions: Socio-economic factors, both for the parents and the person with diabetes, have a strong influence on the development of ESRD in Type 1 diabetes. It is important for caregivers to give enough support to more vulnerable people and their families.

National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-134699 (URN)10.1111/dme.13289 (DOI)000399672200012 ()27862276 (PubMedID)2-s2.0-85010289869 (Scopus ID)
Available from: 2017-06-30 Created: 2017-06-30 Last updated: 2023-03-24Bibliographically approved
Waernbaum, I. & Dahlquist, G. (2016). Low mean temperature rather than few sunshine hours are associated with an increased incidence of type 1 diabetes in children. European Journal of Epidemiology, 31(1), 61-65
Open this publication in new window or tab >>Low mean temperature rather than few sunshine hours are associated with an increased incidence of type 1 diabetes in children
2016 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 31, no 1, p. 61-65Article in journal (Refereed) Published
Abstract [en]

The well-known north-south gradient and the seasonal variability in incidence of childhood type1 diabetes indicate climatological factors to have an effect on the onset. Both sunshine hours and a low temperature may be responsible. In the present study we tried to disentangle these effects that tend to be strongly connected.

Exposure data were sunshine hours and mean temperature respectively obtained from eleven meteorological stations in Sweden which were linked to incidence data from geographically matched areas. Incident cases during 1983-2008 were retrieved from the population based Swedish childhood diabetes register. We used generalized additive models to analyze the incidence as a function of mean temperature and hours of sun adjusted for the time trend, age and sex.

In our data set the correlation between sun hours and temperature was weak (r=0.36) implying that it was possible to estimate the effect of these variables in a regression model. We fit a general additive model with a smoothing term for the time trend. In the model with sun hours we found no significant effect on T1 incidence (p=0.17) whereas the model with temperature as predictor was significant (p=0.05) when adjusting for the time trend, sex and age. Adding sun hours in the model where mean temperature was already present did not change the effect of temperature.

There is an association with incidence of type1 diabetes in children and low mean temperature independent of a possible effect of sunshine hours after adjustment for age, sex and time trend. The findings may mirror the cold effect on insulin resistance and accords with the hypothesis that overload of an already ongoing beta cell destruction may accelerate disease onset.

Place, publisher, year, edition, pages
Springer, 2016
Keywords
Climate, Incidence, Risk factors, Time trend adjustment, Type 1 diabetes mellitus
National Category
Public Health, Global Health, Social Medicine and Epidemiology Endocrinology and Diabetes Pediatrics
Identifiers
urn:nbn:se:umu:diva-101214 (URN)10.1007/s10654-015-0023-8 (DOI)000370376600007 ()2-s2.0-84958780689 (Scopus ID)
Funder
Swedish Research Council, 07531Riksbankens Jubileumsfond, P11-0814:1
Available from: 2015-03-25 Created: 2015-03-25 Last updated: 2023-03-23Bibliographically approved
Berhan, Y., Eliasson, M., Möllsten, A., Waernbaum, I. & Dahlquist, G. (2015). Impact of Parental Socioeconomic Status on Excess Mortality in a Population-Based Cohort of Subjects With Childhood-Onset Type 1 Diabetes. Diabetes Care, 38(5), 827-832
Open this publication in new window or tab >>Impact of Parental Socioeconomic Status on Excess Mortality in a Population-Based Cohort of Subjects With Childhood-Onset Type 1 Diabetes
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2015 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 38, no 5, p. 827-832Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim of this study was to analyze the possible impact of parental and individual socioeconomic status (SES) on all-cause mortality in a population-based cohort of patients with childhood-onset type 1 diabetes.

RESEARCH DESIGN AND METHODS: Subjects recorded in the Swedish Childhood Diabetes Registry (SCDR) from 1 January 1978 to 31 December 2008 were included (n =14,647). The SCDR was linked to the Swedish Cause of Death Registry (CDR) and the Longitudinal Integration Database for Health Insurance and Labour Market Studies (LISA).

RESULTS: At a mean follow-up of 23.9 years (maximum 46.5 years), 238 deaths occurred in a total of 349,762 person-years at risk. In crude analyses, low maternal education predicted mortality for male patients only (P = 0.046), whereas parental income support predicted mortality in both sexes (P < 0.001 for both). In Cox models stratified by age-at-death group and adjusted for age at onset and sex, parental income support predicted mortality among young adults (≥18 years of age) but not for children. Including the adult patient’s own SES in a Cox model showed that individual income support to the patient predicted mortality occurring at ≥24 years of age when adjusting for age at onset, sex, and parental SES.

CONCLUSIONS: Exposure to low SES, mirrored by the need for income support, increases mortality risk in patients with childhood-onset type 1 diabetes who died after the age of 18 years.

National Category
Clinical Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-101362 (URN)10.2337/dc14-1522 (DOI)000353505600023 ()2-s2.0-84958591961 (Scopus ID)
Funder
Swedish Research Council, 07531
Available from: 2015-03-27 Created: 2015-03-27 Last updated: 2023-03-24Bibliographically approved
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