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 Researchers examined medical records for 1,598 veterans who received
treatment for PTSD and had regular assessments to rate their symptom
severity. At the start of the study period, none of the participants
had diabetes, and all of them rated their PTSD symptoms as moderate
to severe, with scores of at least 50 on a scale topping out at 85
for the worst cases.
After two to six years of follow-up, a total of 105 veterans
developed diabetes.
Veterans who experienced a meaningful reduction in PTSD symptoms
over the first year of PTSD treatment - at least a 20-point drop in
symptom severity scores - were 49% less likely to develop diabetes
than those who didn't improve as much.
"Some people consider PTSD a lifelong sentence for poor health, but
this study demonstrates this is not the case if PTSD treatment leads
to clinically meaningful PTSD symptom reduction or if PTSD symptoms
remit spontaneously," said Jeffrey Scherrer, lead author of the
study and a researcher at Saint Louis University School of Medicine
and the Harry S. Truman Veterans Administration Medical Center in
Columbia, Missouri.
"We hope patients who have not sought treatment would see these
results as additional incentive to obtain evidence-based PTSD
psychotherapy," Scherrer said by email.
PTSD has previously been linked to an increased risk of a wide range
of health problems include heart disease, autoimmune disorders,
sexual dysfunction and type 2 diabetes.
Type 2 diabetes is the most common form of the disease and is
typically associated with obesity and aging.
Among veterans who experienced a clinically meaningful reduction in
PTSD symptoms over the first year of treatment, 2.6% developed
diabetes during the study, compared with 5.9% of patients without
that level of improvement in their PTSD, researchers report in JAMA
Psychiatry.
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The lowering of diabetes risk with reduced PTSD symptoms was
independent of whether people had other risk factors for diabetes
like slightly elevated blood sugar or obesity.
The study wasn't designed to prove whether or how severe PTSD
symptoms might lead to diabetes or how reducing PTSD severity might
lower the diabetes risk.
One limitation of the study is that it was too small and too brief
to draw broad conclusions about whether PTSD treatment might lower
the lifetime risk of diabetes, the study team notes. Researchers
also lacked data on specific PTSD symptoms veterans experienced
because they only had data on the severity scores.
There are several ways that PTSD might lead to diabetes, Scherrer
noted.
Chronic stress with PTSD can cause an increase in blood sugar and
directly lead to diabetes, obesity and depression, he said. The
condition can also indirectly lead to diabetes by contributing to
sedentary behavior, heavy drinking, smoking or other negative health
behaviors that are risk factors for diabetes.
"Clearly these behaviors are correlated with a dysfunctional stress
response," Scherrer said. "The pathway to diabetes in patients with
PTSD is likely due to many correlated factors."
SOURCE: https://bit.ly/2k4o6hg JAMA Psychiatry, online August 21,
2019.
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