Decreased PTSD Symptoms Linked to Lower Risk of Type 2 Diabetes

Patients with posttraumatic stress disorder (PTSD) who exhibit clinically significant reductions in symptoms have a lower risk of developing type 2 diabetes (T2D), according to the findings of a study published in JAMA Psychiatry.

PTSD has been linked to an augmented risk of T2D. However, as the study’s lead researcher, Jeffrey Scherrer, Ph.D., professor in Family and Community Medicine at Saint Louis University explained in a press release: “Some long-term chronic health conditions associated with PTSD may be less likely to occur among patients who experience clinically meaningful symptom reduction either through treatment or spontaneous improvement.”

In this retrospective cohort study, researchers assessed Veterans Health Affairs medical record data from 5,916 patients (mean age, 42, 84% male, 66% white) who received PTSD specialty care between 2008 and 2012 and were subsequently followed up through 2015. The patient population of interest had one or more PTSD Checklist (PCL) scores of 50 or higher between 2008 and 2012 as well as a second PCL score within the following 12 months and at least 8 weeks after the first PCL score of 50 or higher. The study index date took place 12 months after the fist PCL score.

Patients were required to be free of T2D diagnosis or an antidiabetic medication at least 12 months before the index date and had to have at least one visit after the index date. The researchers defined patients with clinically significant improvement (≥20-point PCL score decrease) and patients with little to no improvement (<20-point PCL score decrease) by assessing reduction in PCL scores during a 12-month period. The key endpoint of this study was stipulated as incident T2D diagnosed during a follow-up period of two- to six years. Study data analysis were completed during January 2019.

Promising Results

The results of the study showed an that an age-adjusted cumulative incidence of T2D was 2.6% among patients with a clinically meaningful PCL score decrease and 5.9% among patients without a clinically meaningful PCL score decrease (P = .003). Subsequent to adjustment for confounding, the results suggest patients with a clinically meaningful PCL score decrease were significantly less likely to develop T2DM compared with those without a clinically meaningful decrease (hazard ratio, 0.51; 95% CI, 0.26-0.98). The study authors wrote that “a decrease in PCL score, whether through treatment or spontaneous improvement, may help mitigate the greater risk of T2D in patients with PTSD.”

“In patients with only PTSD, clinically meaningful PCL decrease is associated with lower risk for diabetes and in patients with PTSD and depression, we found improvement in PTSD was coupled with a decrease in depression,” Scherrer said. “Thus, decreased risk for type 2 diabetes appears to follow large PTSD symptom decrease and in patients with both PTSD and depression, improvement in both conditions may be necessary to reduce risk for type 2 diabetes.”