oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Being born in Sweden increases the risk for type 1 diabetes: a study of migration of children to Sweden as a natural experiment
Örebro University, School of Health and Medical Sciences. Department of Pediatrics, Mälarsjukhuset, Eskilstuna, Sweden.
Örebro University, School of Health and Medical Sciences. Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
Centre for Health Equity Studies (CHESS), Karolinska Institute Stockholm, Sweden; Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden.
2012 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 1, p. 73-77Article in journal (Refereed) Published
Abstract [en]

Aim: To investigate whether the age of first exposure to a high-incidence country like Sweden determines the risk of T1DM in children with an origin in a low incidence region of the world.

Methods: Register study in a Swedish study population in the age 6–25 years in three categories of residents with an origin in low incidence regions of T1DM (Eastern Europe, East Asia, South Asia and Latin America); 24 252 international adoptees; 47 986 immigrants and 40 971 Swedish-born with two foreign-born parents and a comparison group of 1 770 092 children with Swedish-born parents. Retrieval of a prescription of insulin during 2006 was used as an indicator of T1DM and analysed with logistic regression.

Results: The odds ratios (OR) for T1DM were lower than the Swedish majority population for residents with an origin in the four low incidence regions. Being Swedish-born implied a higher risk for T1DM in the four low incidence study groups compared with the internationally adopted with an OR of 1.68 (CI 1.03–2.73).

Conclusions: Being born in Sweden increases the risk for T1DM in children with an origin in low incidence countries. This may imply that exposures in utero or very early infancy are important risk factors for T1DM

Place, publisher, year, edition, pages
West Sussex, United Kingdom: Wiley-Blackwell, 2012. Vol. 101, no 1, p. 73-77
Keywords [en]
Adoption, children, diabetes type 1, epidemiology, immigration
National Category
Medical and Health Sciences Pediatrics
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-32941DOI: 10.1111/j.1651-2227.2011.02410.xISI: 000297630000025PubMedID: 21767306Scopus ID: 2-s2.0-82955195809OAI: oai:DiVA.org:oru-32941DiVA, id: diva2:683751
Projects
Type 1 diabetes in children with non-Swedish background – epidemiology and clinical outcomeAvailable from: 2014-01-06 Created: 2014-01-06 Last updated: 2018-05-13Bibliographically approved
In thesis
1. Type 1 diabetes in children with non-Swedish background: epidemiology and clinical outcome
Open this publication in new window or tab >>Type 1 diabetes in children with non-Swedish background: epidemiology and clinical outcome
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Sweden holds third place of diabetes incidence in young people after Finland and Sardinia. One fifth of the population is nowadays of foreign descent. We have a substantial number of immigrants from countries where the risk for T1D is considerably lower. Migration as a natural experiment is a concept to assess the risk for diabetes in offspring of immigrant parents and assess the interaction between genetics (genotype) and the impact of environment (phenotype).

Aims: To study the risk of incurring diabetes for children of immigrant parents living in Sweden (I) and further study the risk if the child is born in Sweden or not (II); to specifically study and evaluate if children from East Africa have increased risk to develop T1D (III). To investigate if clinical and sociodemographic status at T1D onset differs between immigrant children compared to their Swedish indigenous peers (IV). Finally to study the clinical outcome and the impact of socio-demographic factors at diabetes onset after three years of treatment (V).

Methods: All five studies are observational, nationwide and population based, on prospectively collected data. Statistics mainly by logistic and linear regressions.

Results: Parental country of origin is a strong determinant for diabetes in the offspring. Children born to immigrant parents seem to keep their low risk compared to their Swedish peers (I). When adding the factor of being born in Sweden, the pattern changed; there was a significantly (p < 0.001) increased risk for T1D if the child was born in Sweden (II). East Africans have a substantial risk for T1D and especially if the children are born in Sweden (III). Immigrant children and adolescents have worse metabolic start at T1D onset compared to their indigenous Swedish peers (IV). After 3 years of treatment, the immigrant children had a sustained higher median HbA1c, compared to their Swedish peers (V).

Conclusions: Genotype and influences during fetal life or early infancy have an important impact for the risk of T1D pointing towards epigenetics playing a substantial role. Children with an origin in East Africa have a high risk of incurring T1D. Immigrant children have worse metabolic start at T1D onset, which sustains after three years of treatment

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2014. p. 59
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 102
Keywords
Type 1 diabetes, HbA1c, children, adolescents, ethnicity, epidemiology, immigration, adoption, socio-demographic, registers
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-32843 (URN)978-91-7529-010-2 (ISBN)
Public defence
2013-04-11, Hörsal C2, Campus USÖ, Universitetssjukhuset, S Grev Rosengatan, 701 85 Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-01-31 Created: 2013-12-19 Last updated: 2017-10-17Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Söderström, UlfÅman, Jan

Search in DiVA

By author/editor
Söderström, UlfÅman, Jan
By organisation
School of Health and Medical Sciences
In the same journal
Acta Paediatrica
Medical and Health SciencesPediatrics

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 150 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf