Childhood trauma may raise risk of type 1 diabetes

Traumatic events during childhood may increase kids' risk of developing type 1 diabetes, a Swedish study suggests.

The researchers questioned more than 10,000 families and found that children who experienced an extremely stressful life event – like divorce, illness or death in the family – were about three times more likely to develop type 1 diabetes.

The link doesn't prove trauma causes diabetes, but it does raise the possibility that mental health care or stress reduction could play a role in prevention, researchers said.

"We know that there are connections between the brain and immune system, and it is not surprising that psychological trauma can influence the immune balance and contribute to abnormal reactions" including the development of type 1 diabetes, study coauthor Dr. Johnny Ludvigsson, a pediatrics researcher at Linkoping University in Sweden, said by email.

Type 1 diabetes is an autoimmune disease in which the pancreas stops making insulin, a hormone that helps cells use sugar for energy. When the immune system attacks and destroys insulin-producing cells in the pancreas, called beta cells, diabetes occurs.

Thousands of people worldwide are diagnosed with type 1 diabetes each year. Millions have the more common form of the disease, known as type 2, which is linked to obesity and advanced age and does not involve destruction of beta cells.

Ludvigsson and colleagues invited all families in southeast Sweden with babies born between October 1997 and September 1999 to complete questionnaires distributed during routine physicals and by mail.

The researchers found that a serious traumatic event during the first 14 years of life increased the risk of type 1 diabetes, even after taking into account the family history for any form of diabetes as well as other factors such as the child's age and the parents' education level and marital status.

For the children in the study, having a severe injury or illness, having a parent with a severe injury or illness, or having someone close to them die or become sick was associated with a higher risk for developing type 1 diabetes.

That link remained even after adjusting for children’s overweight or obesity.

While some previous research has tied type 2 diabetes to chronic or severe stress, the current study is among the first to suggest that these same factors may contribute to the development of type 1 diabetes, Dr. Frans Pouwer, a psychologist at Tilburg University in the Netherlands, said by email.

Pouwer, who wasn't involved in the study, noted that more research is needed to firmly establish this link for type 1 diabetes.

"Other studies have looked at the potential role between stressful events, exposure to stress and diabetes onset and they have not been conclusive," said Dr. David Marrero, president of health care and education at the American Diabetes Association and a diabetes researcher at the Indiana University School of Medicine.

Even so, parents can take steps to reduce stress in their children's lives and encourage kids to get plenty of exercise and eat healthy food, Marrero said. It may not prevent type 1 diabetes, but it can lower the risk of developing type 2. "If it's type 2 you can lose weight and increase physical activity and really reduce the risk if you have a genetic or family link," he said.

For type 1, where origins aren't as well understood, it's possible, but not proven, that trauma could increase the risk, Marrero said.

"I wouldn't say 'my kid is exposed to a stressful event and they are therefore definitely going to get diabetes,' but I would say the connection is worth exploring and there is no downside to trying to avoid exposing children to stressful or traumatic situations."