Hospitalization because of diabetes and bereavement: a national cohort study of parents who lost a child

Aims  To examine whether parents who lost a child have an increased risk of hospitalization because of Type 1 or Type 2 diabetes. Methods  We identified all parents who lost a child in Denmark from 1980 to 1996 (stress exposed), and compared them with parents randomly selected from all other parents in the country at that time without such a bereavement. Fifteen non‐bereaved families were matched to each bereaved family for family size and the age of the children. First hospitalizations for Type 1 or Type 2 diabetes were monitored in these two groups up to 18 years after the bereavement. There were 21 062 parents in the bereaved cohort and 293 745 parents in the non‐bereaved cohort. The study was based upon linkage of several national registers, and first‐time hospitalization with diabetes (Type 1 or Type 2) was the end point. Results  Five hundred and fifty‐one cases were hospitalized because of Type 1 diabetes and 1569 cases because of Type 2 diabetes. There was a 29% higher risk of hospitalization because of Type 1 diabetes [95% CI −5 to 75%; corresponding to a relative risk (RR) of 1.29; 95% CI 0.95–1.75] and a 44% higher risk of hospitalization because of Type 2 diabetes (95% CI 21–71%; corresponding to an RR of 1.44; 95% CI 1.21–1.71) in the bereaved cohort. The high risk of hospitalization because of Type 2 diabetes following bereavement was only statistically significant for mothers. Conclusions  Psychological stress may be a contributing cause of, or have prognostic importance for, both Type 1 and Type 2 diabetes, but a statistically significant association was only seen for Type 2 diabetes.