Impact of Parental Socioeconomic Status on Excess Mortality in a Population-Based Cohort of Subjects With Childhood-Onset Type 1 Diabetes

OBJECTIVE: The aim of this study was to analyze the possible impact of parental and individual socioeconomic status (SES) on all-cause mortality in a population-based cohort of patients with childhood-onset type 1 diabetes.RESEARCH DESIGN AND METHODS: Subjects recorded in the Swedish Childhood Diabetes Registry (SCDR) from 1 January 1978 to 31 December 2008 were included (n =14,647). The SCDR was linked to the Swedish Cause of Death Registry (CDR) and the Longitudinal Integration Database for Health Insurance and Labour Market Studies (LISA).RESULTS: At a mean follow-up of 23.9 years (maximum 46.5 years), 238 deaths occurred in a total of 349,762 person-years at risk. In crude analyses, low maternal education predicted mortality for male patients only (P = 0.046), whereas parental income support predicted mortality in both sexes (P < 0.001 for both). In Cox models stratified by age-at-death group and adjusted for age at onset and sex, parental income support predicted mortality among young adults (≥18 years of age) but not for children. Including the adult patient’s own SES in a Cox model showed that individual income support to the patient predicted mortality occurring at ≥24 years of age when adjusting for age at onset, sex, and parental SES.CONCLUSIONS: Exposure to low SES, mirrored by the need for income support, increases mortality risk in patients with childhood-onset type 1 diabetes who died after the age of 18 years.

Eliasson, MatsUmeå universitet,Medicin,Umeå universitet, Medicin(Swepub:umu)mael0021 (author)
Möllsten, AnnaUmeå universitet,Pediatrik,Umeå universitet, Pediatrik(Swepub:umu)anmo0004 (author)
Waernbaum, IngeborgUppsala universitet,Umeå universitet,Statistik,Statistiska institutionen,Umeå universitet, Statistik(Swepub:uu)ingwa901 (author)
Dahlquist, GiselaUmeå universitet,Pediatrik,Umeå universitet, Pediatrik(Swepub:umu)gida0001 (author)
Umeå universitetPediatrik (creator_code:org_t)

In:Diabetes Care: American Diabetes Association38:5, s. 827-8320149-59921935-5548

By the author/editor: Berhan, Yonas; Eliasson, Mats; Möllsten, Anna; Waernbaum, Ingeb ...; Dahlquist, Gisel ...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Public Health Gl ...

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