title: Relationship between posttraumatic stress disorder and type 2 diabetes in a population-based cross-sectional study with 2970 participants.
abstract: OBJECTIVE
  To evaluate the association of posttraumatic stress disorder (PTSD) with type 2 diabetes (T2D) or prediabetes in a large population-based sample.
  
  
  METHODS
  In 2970 subjects (aged 32-81 years) drawn from the population-based cross-sectional study KORA F4 from the Augsburg region (Southern Germany) a PTSD screening was performed employing the posttraumatic diagnostic scale, the impact of event scale, and interview data. The exposure variable PTSD was sub-classified into partial and full PTSD and additionally in subjects with traumatic event but no PTSD" to "The exposure variable PTSD was classified into (1) no traumatic event (2) traumatic event, but no PTSD, (3) partial PTSD, (4) full PTSD. A total of 50 (1.7%) subjects qualified for full PTSD, whereas 261 (8.8%) qualified for partial PTSD. A total of 333 subjects (11.2%) suffered from T2D and 498 (16.8%) from prediabetes as assessed by an oral glucose tolerance test and physicians' validation. The associations of PTSD with T2D and prediabetes were estimated by multinomial logistic regression analyses with adjustments for sociodemographic characteristics, metabolic risk factors or psychopathological conditions.
  
  
  RESULTS
  In the model adjusted for sociodemographic characteristics and metabolic risk factors, full PTSD was significantly associated with T2D (OR: 3.90, 95% CI: 1.61-9.45, p=0.003) compared to subjects with no traumatic event. Significance remained after additional adjustment for other psychopathological conditions (OR: 3.56, 95% CI: 1.43-8.85, p=0.006). Regarding prediabetes, no significant associations were observed.
  
  
  CONCLUSIONS
  Suffering from PTSD might activate chronic stress symptoms and trigger physiological mechanisms leading to T2D. Prospective studies are needed to investigate temporal and causal relationships between PTSD and T2D.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University of Gießen, Gießen, Germany.
authors.forename: Karoline
authors.initials: K
authors.lastname: Lukaschek
authors.forename: Jens
authors.initials: J
authors.lastname: Baumert
authors.forename: Johannes
authors.initials: J
authors.lastname: Kruse
authors.forename: Rebecca Thwing
authors.initials: RT
authors.lastname: Emeny
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Lacruz
authors.forename: Cornelia
authors.initials: C
authors.lastname: Huth
authors.forename: Barbara
authors.initials: B
authors.lastname: Thorand
authors.forename: Rolf
authors.initials: R
authors.lastname: Holle
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Ladwig
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005858:Germany; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000175:diagnosis