Psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among American Indians in the Strong Heart Family Study.
OBJECTIVE
The aims of this paper are to examine the relationship between psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among 3776 American Indians in Phase V of the Strong Heart Family Study.


METHODS
This cross-sectional analysis measured psychological trauma symptoms using the National Anxiety Disorder Screening Day instrument, diabetes by American Diabetes Association criteria, and treatment modality by four categories: no medication, oral medication only, insulin only, or both oral medication and insulin. We used binary logistic regression to evaluate the association between psychological trauma symptoms and diabetes prevalence. We used ordinary least squares regression to evaluate the association between psychological trauma symptoms and glucose control. We used binary logistic regression to model the association of psychological trauma symptoms with treatment modality.


RESULTS
Neither diabetes prevalence (22%-31%; p=0.19) nor control (8.0-8.6; p=0.25) varied significantly by psychological trauma symptoms categories. However, diabetes treatment modality was associated with psychological trauma symptoms categories, as people with greater burden used either no medication, or both oral and insulin medications (odds ratio=3.1, p<0.001).


CONCLUSIONS
The positive relationship between treatment modality and psychological trauma symptoms suggests future research investigate patient and provider treatment decision making.
University of San Diego Department of Ethnic Studies & Heritage University Center for Native Health & Culture, 5998 Alcala Park, Maher 206, San Diego, CA 92110, USA. Electronic address: mjacob@sandiego.edu.
Michelle M
MM
Jacob
Kelly L
KL
Gonzales
Darren
D
Calhoun
Janette
J
Beals
Clemma Jacobsen
CJ
Muller
Jack
J
Goldberg
Lonnie
L
Nelson
Thomas K
TK
Welty
Barbara V
BV
Howard
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007198:Indians, North American; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013315:Stress, Psychological / Q000097:blood / Q000150:complications / Q000453:epidemiology*
D001786:Blood Glucose
American Indians; Diabetes treatment modality; Psychological trauma symptoms