title: Post-traumatic stress disorder and diabetes: co-morbidity and outcomes in a male veterans sample.
abstract: The purpose of this study was to assess the prevalence and correlates of comorbid diabetes and Post-Traumatic Stress disorder(PTSD)and potential relationships between PTSD and diabetes outcomes. Male patients enrolled in a VA primary care database (N = 73,270) were classified as having diabetes from pharmacy records (N = 14,438) and grouped into those with diagnoses of PTSD with depression (N = 649), PTSD-only (N = 480), Depression-only (N = 1696), Other psychiatric diagnosis (N = 736), or No psychiatric diagnosis (N = 10,877) based on the Purpose of Visit diagnoses in the medical record. Outcomes included glycemic control (HbA1c), cholesterol and triglycerides. Correlates were age, substance use disorder, other psychiatric diagnosis, number of primary care encounters, and medications. The prevalence of comorbid diabetes and PTSD was 8% (n = 1129). Of these, 57% (n = 649) had comorbid depression. Patients with PTSD and depression had higher rates of substance use disorder and higher cholesterol and LDL. Patients with depression had poorer glycemic control. Patients with PTSD and depression weighed more and had higher BMI than patients with neither diagnosis. Thus, male diabetes patients with PTSD and depression may be vulnerable to substance use disorders and to weight/lipid problems that can affect health. Depression is a likely contributor to poor glycemic control. Careful screening for mental health comorbidities is needed for diabetes patients.
authors.affiliation: Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, NY, USA.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Trief
authors.forename: Paige
authors.initials: P
authors.lastname: Ouimette
authors.forename: Michael
authors.initials: M
authors.lastname: Wade
authors.forename: Paul
authors.initials: P
authors.lastname: Shanahan
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003130:Combat Disorders / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000097:blood / Q000453:epidemiology / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000097:blood / Q000453:epidemiology / Q000523:psychology; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000523:psychology / Q000706:statistics & numerical data; D014280:Triglycerides / Q000097:blood; D014728:Veterans / Q000523:psychology*
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D014280:Triglycerides