21 Aug Meaningful PTSD Improvement Associated with Lower Risk of Diabetes
MedicalResearch.com Interview with:
Jeff Scherrer, Ph.D.
Associate professor; Research director
Department of Family and Community Medicine
Saint Louis University Center for Health Outcomes Research
MedicalResearch.com: What is the background for this study?
Response: This study was part of a larger NIH grant to determine if PTSD is associated with poor health behaviors and subsequently whether PTSD remains an independent risk factor for diabetes and heart disease. Our second focus of the grant was to measure if those patients who experience clinically meaningful PTSD improvement have improved health behaviors (e.g. seeking help to lose weight) and a lower risk for diabetes and heart disease.
The rationale for this study of PTSD improvement and lower risk for diabetes is supported from other investigators’ findings that PTSD treatment completion is often followed by improvement in sleep, depression, pain and general physical complaints and lower blood pressure. Because we have found the association between PTSD and incident diabetes is largely explained by obesity, depression and other comorbid conditions that are more common in patients with vs. without PTSD, we hypothesized that improvements in PTSD would be associated with lower risk of diabetes either directly or due to improvements in these comorbid diabetes risk factors.
MedicalResearch.com: What are the main findings?
Response: The primary finding is that large clinically meaningful PTSD improvement, compared to no improvement or less than large improvement, is associated with about a 50% lower risk for incident type 2 diabetes. In patients with both PTSD and depression, lower diabetes risk was associated with dual improvement in depression symptoms but not associated with a change in weight or A1c scores.
MedicalResearch.com: What should readers take away from your report?
Response: This study highlights the potential to modify chronic disease risk, which is greater in persons with common psychiatric disorders, by successful treatment or spontaneous remission of symptoms. Patients may consider the secondary health benefits when deciding to complete PTSD psychotherapy.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: There are numerous measures not available in medical record data that should be evaluated as mechanisms underlying the association between PTSD improvement and lower risk for diabetes. Longer follow-up time is needed to determine if lower diabetes risk persists and what are the consequences of recurrence of PTSD or comorbid depression symptoms on life-long risk for diabetes and cardiovascular disease.
Disclosures – I receive funding from NIH and compensation for service as Editor, Family Practice.
Scherrer JF, Salas J, Norman SB, et al. Association Between Clinically Meaningful Posttraumatic Stress Disorder Improvement and Risk of Type 2 Diabetes. JAMA Psychiatry. Published online August 21, 2019. doi:10.1001/jamapsychiatry.2019.2096
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