title: Hospitalization because of diabetes and bereavement: a national cohort study of parents who lost a child.
abstract: OBJECTIVE
  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.
authors.affiliation: The Danish Epidemiology Science Centre, Department of Epidemiology and Social Medicine, University of Aarhus, Aarhus, Denmark. jo@UCLA.edu
authors.forename: J
authors.initials: J
authors.lastname: Olsen
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: D H
authors.initials: DH
authors.lastname: Precht
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001601:Bereavement; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000209:etiology* / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000523:psychology; D010287:Parent-Child Relations; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological