{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:08:29Z","timestamp":1792782509121,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008550","name":"Diabetesfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008550","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det om H\u00e4lsa, Arbetsliv och V\u00e4lf\u00e4rd","doi-asserted-by":"publisher","award":["2020-00372"],"award-info":[{"award-number":["2020-00372"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Swedish Child Diabetes Foundation"},{"name":"The Family Ernfors Fund"},{"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":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\/hypothesis<\/jats:title>\n                    <jats:p>The aim of this study was to quantify the impact of childhood-onset type 1 diabetes on parental incomes in a Nordic welfare state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this register-based quasi-experimental study, we included the parents of 13,358 children diagnosed with type 1 diabetes in Sweden from 1993 to 2014 together with 506,516 population-based matched control parents. A difference-in-differences approach was used to compare income trajectories between exposed parents and control parents. Work-related and pension-qualifying incomes (including parental benefits) were assessed during the first 7 years after diagnosis. The long-term incomes of parents of children diagnosed with type 1 diabetes in 1993\u20132004 were also investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A sharp decline in work-related income was observed in both mothers and fathers of children diagnosed with type 1 diabetes. In the year after diagnosis, the mean yearly income difference (expressed in \u20ac100) was \u201315.4 for mothers (95% CI \u201317.2, \u201313.6) and \u20136.0 for fathers (95% CI \u20138.9, \u20133.2), representing a relative decrease of 6.6% and 1.6%, respectively. The effects on income were similar across sociodemographic groups and calendar periods. The pension-qualifying income of mothers increased in the first year after diagnosis by 28.7 (95% CI 27.1, 30.3), attributable to the parental care allowance, but gradually decreased during long-term follow-up (\u201310.9, 95% CI \u201316.6, \u20135.1, after 17 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\/interpretation<\/jats:title>\n                    <jats:p>This study highlights the enduring financial consequences for parents caring for a child with type 1 diabetes in Sweden. While parental benefits in Sweden mitigated the short-term loss of maternal income, the current welfare system does not adequately address long-term consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00125-025-06492-6","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T16:40:39Z","timestamp":1754671239000},"page":"2168-2178","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of child type 1 diabetes on parental incomes in a welfare state context: quasi-experimental evidence from Swedish national registers"],"prefix":"10.1007","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0066-4814","authenticated-orcid":false,"given":"Beatrice","family":"Kennedy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8845-8846","authenticated-orcid":false,"given":"Mona-Lisa","family":"Wernroth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3888-2910","authenticated-orcid":false,"given":"Sophie","family":"Langenski\u00f6ld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1189-9950","authenticated-orcid":false,"given":"Carl","family":"Bonander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4421-6466","authenticated-orcid":false,"given":"Liisa","family":"Byberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6209-4407","authenticated-orcid":false,"given":"Erik","family":"Gr\u00f6nqvist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2071-5866","authenticated-orcid":false,"given":"Tove","family":"Fall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"6492_CR1","volume-title":"Diabetes (type 1 and type 2) in children and young people: diagnosis and management","author":"National Institute for Health and Care Excellence (NICE)","year":"2023","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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ISF, https:\/\/isf.se\/, G\u00f6teborg [in Swedish]"}],"container-title":["Diabetologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00125-025-06492-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00125-025-06492-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00125-025-06492-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T10:04:25Z","timestamp":1757498665000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00125-025-06492-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":23,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["6492"],"URL":"https:\/\/doi.org\/10.1007\/s00125-025-06492-6","relation":{},"ISSN":["0012-186X","1432-0428"],"issn-type":[{"value":"0012-186X","type":"print"},{"value":"1432-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]},"assertion":[{"value":"13 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"We thank the parents who participated in a parental focus group to share their experiences of the financial impact of parenting children with type 1 diabetes, thereby contributing to the rationale for our project. Preliminary findings from the current study were presented to the group, and the parents had the opportunity to reflect on the results. The group did not participate in the interpretation of the results or the writing of the manuscript. Our findings were presented at the Swedish \u2018Endodiabetes\u2019 conference, held in Link\u00f6ping, Sweden, in March 2025. No preprint has been published.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"Restrictions apply to the availability of the data, which were used under license and ethical approval and are not publicly available. However, data are available from the corresponding author 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 research was partly funded by Forte, the Swedish Research Council for Health, Working Life and Welfare (2020-00372), through a grant awarded to TF, and by the Swedish Diabetes Foundation, the Swedish Child Diabetes Foundation, and the Family Ernfors Fund through grants awarded to BK. BK was further supported by a Gullstrand Research Fellow grant from Uppsala University Hospital. The funders had no role in the study design, data collection, analysis, interpretation, manuscript writing or the decision to submit the article for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"TF is a member of the editorial board of\n                      Diabetologia\n                      . The authors declare that there are no other 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, SL, CB, LB, EG and TF. TF and BK 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 have approved the final version for publication. BK is the guarantor of this work and affirms that this manuscript is an honest, accurate and transparent account of the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}