Diabetes, PTSD Linked?

By Sridhar Nadamuni , May 16, 2013 10:37 AM EDT

Chronic and sustained stress throws your hormones haywire and revs up type 2 diabetes, German researchers report.

Posttraumatic stress disorder (PTSD) is a prolonged stress response syndrome involving symptoms that develop in the wake of extremely stressful life events of an extraordinarily threatening or catastrophic nature. The symptoms of PTSD include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts, intrusive memories, avoidance and numbing, or emotional arousal. The experiences from traumatic events can be managed with time and patience, but in some individuals the symptoms can  get worse, and out of control, shaking up their lives.

It is not surprising that PTSD is most often reported among the military personnel returning from war zones, e.g. Afghanistan or Iraq, or other battle fields.  The soldiers often have first-hand experience of events or threats that involved death or serious injury. They may relive the experience with emotionally distressing images and memories, upsetting dreams, flashbacks or even physical reactions. The individuals may also be constantly on guard or alert for signs of danger, which may make it difficult to sleep or concentrate. Often, these symptoms make it impossible to go through life or normal daily living tasks. PTSD is confirmed if these symptoms persist over a month.

The consequences can be devastating: Cardiovascular disease, chronic pain, autoimmune diseases, such as rheumatoid arthritis and thyroid disease, and musculoskeletal conditions are some of the complications, according to experts at the Mayo Clinic.

Researchers now show that PTSD in turn leads to a significant risk of developing type 2 diabetes.

Dr. Karoline Lukaschek from the Institute of Epidemiology II (EPI II) at the Helmholtz Zentrum München (HMGU) and Prof. Johannes Kruse from the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen and Marburg, and their colleagues from the Helmholtz Zentrum München and the University Hospital Gießen and Marburg now provide the first evidence of a signficant association between the two illnesses.

In the study published in the Journal of Psychosomatic Research, the investigators looked into data from a population-based study in which the data were collected by means of a standardized survey of all participants and also a glucose tolerance test. They identified 50 participants with PTSD, and an additional 261 with symptoms of partial PTSD. They also included 498 participants who suffered from full-blown type 2 diabetes and 333 subjects who  displayed signs of a pre-diabetic condition. The analysis showed a significant association between type 2 diabetes and PTSD. However, prediabetes was not associated with psychological stress. The scientists explain that the chronic and permanent stress among PTSD patients leads to changes in the hormonal response, with the result that the body's metabolism and glucose utilization are adversely affected. More studies are needed to dig into the detailed mechanisms, the temporal and causal relationships.

"Further clarification of the relationships between psychological factors and metabolic disorders will be an important task for diabetes research in the future", commented Prof. Karl-Heinz Ladwig, research group leader at EPI II.

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