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Improvement in PTSD symptoms linked to lower risk for diabetes

Researchers reported that clinically meaningful improvement in PTSD symptoms compared with less than clinically meaningful or no improvement was linked to a 49% lower risk for incident type 2 diabetes.

Although prior research had indicated a link between PTSD and increased risk for type 2 diabetes, no research has determined whether clinically meaningful reduction in PTSD symptoms is linked to lower risk for incident type 2 diabetes, Jeffrey F. Scherrer, PhD, of Saint Louis University School of Medicine, and colleagues wrote in JAMA Psychiatry.

Scherrer and colleagues conducted a retrospective cohort study using Veterans Health Affairs medical record data from 1,598 patients who received PTSD specialty care between 2008 and 2012, and were followed up through 2015. Researchers classified reduction in PTSD Checklist (PCL) scores during a 12-month period based as achieving clinically meaningful improvement (defined as a 20 or more point decrease in PCL score) or as less or no improvement (defined as a less than 20 point PCL score decrease).

The results showed that the cumulative incidence of type 2 diabetes was higher among patients without a clinically meaningful PCL score decrease than among those with a clinically meaningful score decrease (5.9% vs. 2.6%; P = .003).

After adjusting for confounding, analysis indicated that patients with a clinically meaningful improvement in PTSD symptoms were less likely to develop diabetes than those without clinically meaningful improvement (HR = 0.51; 95% CI, 0.26-0.98). These findings were independent of psychiatric and physical comorbidities, according to the results.

“The association was also independent of the number of PTSD psychotherapy sessions used, suggesting that a healthy adherer effect, or a general orientation to improve health, is unlikely to explain our observations,” Scherrer and colleagues wrote. “Patient education regarding potential health benefits of PTSD treatment may incentive psychotherapy use.”

Also, in post hoc analysis limited to 433 patients with only PTSD and without depression, the incidence rate of type 2 diabetes was also higher among patients who did not experience a clinically meaningful PCL score reduction than those who did (12.4 vs. 2 per 1,000 person-years), the results revealed.

“On the basis of our main analyses, among patients with PTSD who had comorbid depression, a reduction in PTSD symptoms and depression was associated with lower risk for T2D,” the researchers wrote. “These findings suggest that improved depression does not account for our results but may be a necessary component for an association with lower T2D risk among patients with PTSD and comorbid depression.” – by Savannah Demko

Disclosures: Scherrer reports grants from the National Heart, Lung and Blood Institute. Please see the study for all other authors’ relevant financial disclosures.