{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T22:05:29Z","timestamp":1757541929024,"version":"3.37.3"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Swedish Diabetes Foundation","award":["Grant awarded Beatrice Kennedy"],"award-info":[{"award-number":["Grant awarded Beatrice Kennedy"]}]},{"name":"The Swedish Child Diabetes Foundation","award":["Grant awarded Beatrice Kennedy"],"award-info":[{"award-number":["Grant awarded Beatrice Kennedy"]}]},{"name":"The Swedish Society of Medicine","award":["Grant awarded Beatrice Kennedy"],"award-info":[{"award-number":["Grant awarded Beatrice Kennedy"]}]},{"name":"The Nils Erik Holmsten Foundation","award":["Grant awarded Beatrice Kennedy"],"award-info":[{"award-number":["Grant awarded Beatrice Kennedy"]}]},{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det om H\u00e4lsa, Arbetsliv och V\u00e4lf\u00e4rd","doi-asserted-by":"publisher","award":["Grant awarded Tove Fall (2020-00372)"],"award-info":[{"award-number":["Grant awarded Tove Fall (2020-00372)"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Family Ernfors Fund","award":["Grant awarded Beatrice Kennedy"],"award-info":[{"award-number":["Grant awarded Beatrice Kennedy"]}]},{"name":"The P. O. Zetterling Foundation","award":["Grant awarded Beatrice Kennedy"],"award-info":[{"award-number":["Grant awarded Beatrice Kennedy"]}]},{"DOI":"10.13039\/501100007051","name":"Uppsala University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007051","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diabetologia"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Aims\/hypothesis<\/jats:title>\n                <jats:p>Parenting a child with type 1 diabetes has been associated with stress-related symptoms. This study aimed to elucidate the potential impact on parental risk of major cardiovascular events (MCE) and death.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this register-based study, we included the parents of 18,871 children, born 1987\u20132020 and diagnosed with type 1 diabetes in Sweden at &lt;18 years. The median parental age at the child's diagnosis was 39.0 and 41.0 years for mothers and fathers, respectively. The cohort also encompassed 714,970 population-based matched parental control participants and 12,497 parental siblings. Cox proportional hazard regression models were employed to investigate the associations between having a child with type 1 diabetes and incident MCE and all-cause death, and, as secondary outcomes, acute coronary syndrome and ischaemic heart disease (IHD). We adjusted for potential confounders including parental type 1 diabetes and country of birth.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>During follow-up (median 12 years, range 0\u201335), we detected no associations between parenting a child with type 1 diabetes and MCE in mothers (adjusted HR [aHR] 1.02; 95% CI 0.90, 1.15) or in fathers (aHR 1.01; 95% CI 0.94, 1.08). We noted an increased hazard of IHD in exposed mothers (aHR 1.21; 95% CI 1.05, 1.41) with no corresponding signal in fathers (aHR 0.97; 95% CI 0.89, 1.05). Parental sibling analysis did not confirm the association in exposed mothers (aHR 1.01; 95% CI 0.73, 1.41). We further observed a slightly increased hazard of all-cause death in exposed fathers (aHR 1.09; 95% CI 1.01, 1.18), with a similar but non-significant estimate noted in exposed mothers (aHR 1.07; 95% CI 0.96, 1.20). The estimates from the sibling analyses of all-cause death in fathers and mothers were 1.12 (95% CI 0.90, 1.38) and 0.73 (95% CI 0.55, 0.96), respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions\/interpretation<\/jats:title>\n                <jats:p>Having a child diagnosed with type 1 diabetes in Sweden was not associated with MCE, but possibly with all-cause mortality. Further studies are needed to disentangle potential underlying mechanisms, and to investigate parental health outcomes across the full lifespan.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00125-024-06200-w","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T08:02:24Z","timestamp":1719388944000},"page":"1828-1837","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Major cardiovascular events and death in parents of children with type 1 diabetes: a register-based matched cohort study in Sweden"],"prefix":"10.1007","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0066-4814","authenticated-orcid":false,"given":"Beatrice","family":"Kennedy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8845-8846","authenticated-orcid":false,"given":"Mona-Lisa","family":"Wernroth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2480-9547","authenticated-orcid":false,"given":"Gorav","family":"Batra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8367-5000","authenticated-orcid":false,"given":"Ulf","family":"Hammar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3308-9886","authenticated-orcid":false,"given":"Cecilia","family":"Linroth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8502-8568","authenticated-orcid":false,"given":"Annika","family":"Gr\u00f6nberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4421-6466","authenticated-orcid":false,"given":"Liisa","family":"Byberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2071-5866","authenticated-orcid":false,"given":"Tove","family":"Fall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"key":"6200_CR1","unstructured":"National Institute for Health and Care Excellence (NICE) (2023) Diabetes (type 1 and type 2) in children and young people: diagnosis and management. 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Berne, Department of Medical Sciences, Uppsala University, for his highly valuable scientific input and encouragement during the initial phase of the study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"Restrictions apply to the availability of these data, which were used under license and ethical approval and are not publicly available. Data are, however, available from the authors upon reasonable request and with written permission of the Swedish Ethical Review Authority, subject to legal contracts regarding the General Data Protection Regulation (GDPR) and Personal Data Processing Agreements between Uppsala University and the receiving research entity.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"Open access funding provided by Uppsala University. This study received financial support from the Swedish Diabetes Foundation, the Swedish Child Diabetes Foundation, the Swedish Society of Medicine, the Family\u00a0Ernfors\u00a0Fund, the P. O. Zetterling Foundation and the Nils Erik Holmsten Foundation, all through grants awarded to BK. This research was further funded in part by Forte (2020-00372), through a grant awarded to TF. The funders had no role in the study design or the collection, analysis, or interpretation of data, the writing of the report, or the decision to submit the article for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"The study was designed by BK, M-LW, LB and TF. BK and TF obtained the funding, BK acquired the data, M-LW performed the statistical analysis, and BK wrote the first draft. All authors contributed with invaluable support for data analyses, interpretation of findings and critical revision of the article, and approved the final version for publication. BK is the guarantor of this work and, as such, has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}