Diabetes and post-traumatic stress disorder are two unrelated health issues. However, recent research studies have indicated an alarming relationship between the two medical conditions. PTSD is a mental illness that may be caused by exposure to or witnessing a traumatic event. It has been associated with the development and progression of diabetes. This blog post will examine how is diabetes secondary to PTSD, the mechanisms behind this association, and the implications for people living with both conditions.

What is PTSD?

PTSD is the condition that leads to mental health disorders from the experience of or witnessing some traumatic event; this can range from combat and physical assault, natural disasters, to severe accidents. People with PTSD usually have symptoms of flashbacks and nightmares, they are always on alert, anxious, depressed, or emotionally numb. Changes in mood, cognition, and behavior tend to be commonly associated with people suffering from PTSD, and indeed, it’s a serious barrier to life quality.

Understanding Diabetes

Diabetes is a chronic condition characterized by high blood sugar levels resulting from the body’s inability to produce enough insulin or effectively use the insulin it makes. The two main forms of diabetes are Type 1, where the immune system attacks cells that produce insulin in the pancreas, and Type 2, which is linked to factors of lifestyle like bad diet, sedentary lifestyle, and obesity. Both of these conditions require blood sugar to be very well controlled so that the complications of heart disease, nerve damage, and kidney problems are avoided.

Steps to know How is diabetes secondary to PTSD

The mechanisms through which PTSD contributes to the onset of diabetes remain under study. Still, research findings have started unfolding various mechanisms through which PTSD might contribute to diabetes, mostly Type 2. Here are the major factors that explain this link:

1. Chronic Stress and Its Impact on Blood Glucose

PTSD intrinsically incorporates chronic stress in its nature. The body experiences many hormones released with stress, including but not limited to cortisol and adrenaline. These are part of what is called in the body “fight or flight,” or in other words, the quick response system designed to work appropriately for short terms but can very easily be deadly if used long term. Chronic stress leads to higher cortisol levels due to continuous activation, which elevates the blood sugar in the body. Elevated cortisol leads to insulin resistance, which is a state where the body’s cells do not respond appropriately to insulin. Therefore, it becomes challenging for the regulation of blood sugar. This, over time, may lead to the occurrence of Type 2 diabetes.

2. Unhealthy Coping Mechanisms

Most of the patients with PTSD will engage in unhealthy ways of coping, such as bingeing on food, drinking alcohol, or smoking. All these are risk factors for obesity development. This is one of the major risk factors for developing Type 2 diabetes. Emotional eating primarily consists of consuming calorie-dense but nutritionally poor foodstuffs, which can cause blood sugar levels to shoot and potentially lead to weight gain. Moreover, alcohol and smoking further compromise the metabolic status and increase the tendency for diabetes development.

3. Sleep Disorders and Insulin Sensitivity

The central symptom of insomnia, a sleep disorder, difficulty in sleeping, might include nightmares and inability to sleep due to this insomnia and disordered sleep-wake cycles, causing lowered sensitivity of insulin levels. Higher insulin resistance brings an increase in the blood glucose levels. Over extended periods of disturbed sleep, elevated hunger, and craving high carbohydrates, sugar-rich food intake raises levels of blood sugars that would further imbalance this blood sugar cycle with weight addition.

4. Inflammation and Dysfunctional Immunity

Both PTSD and diabetes, for that matter, cause elevated inflammation within the body. Long-term activation of the body’s inflammatory response due to PTSD will put a burden on the function of vital organs and tissues involved in such activities as regulating blood sugar. Chronic inflammation highly contributes to the development of insulin resistance since it complicates the regulation process of blood glucose levels in the body. Furthermore, such an immune dysfunction caused by PTSD may further be a cause to delay glucose metabolism in the body.

5. Changes in Brain Function and Behavior

Besides the impact of PTSD on structure and function in the brain, especially in the hippocampus and prefrontal cortex, which control stress regulation and decision-making functions, it can alter how people process emotions, control stress, and make health decisions. Patients with PTSD might, therefore, often find themselves not complying with healthy lifestyles, such as eating nutritious meals, doing physical exercise, and adhering to medical recommendations, which increases the risk for diabetes.

The Impact of Co-occurring PTSD and Diabetes

PTSD, coupled with diabetes, is an issue that, in itself, will challenge the individual to cope. PTSD complicates the physical aspects of diabetes, such as frequent blood glucose checks, strict medication plans, and generally keeping a healthy lifestyle. More importantly, emotional and psychological manifestations of PTSD might discourage an individual from staying interested in managing their diabetes. The research evidence suggests that patients with the comorbidity of PTSD and diabetes tend to have poor health outcomes. They are more likely to have incidence complications such as heart disease, kidney disease, and nerve damage, besides the higher mental problems. They are also disposed toward depression and anxiety problems.

1. Increased Risk of Complications

The effects of chronic stress and lack of proper care for both patients with diabetes may increase their likelihood of experiencing other complications as a result of PTSD. Moreover, managing the several needs of diabetes will be very hard for those people suffering from medication adherence as well because most of them who have PTSD also experience symptoms that include anxiety and hypervigilance, which may increase the rate of hospitalization and emergency care as well as long-term problems.

2. Diabetes Management in the Context of Mental Health Issues

Diabetes management requires attention to diet, exercise, and medication over a long period. PTSD increases the burden associated with attention to these activities through anxiety, flashbacks, and emotional distress that characterizes individuals with PTSD. These aspects will negatively impact treatment adherence, therefore leading to poor glycemic control and increasing the risk of complications associated with diabetes.

What can be done for the two conditions together?

Given the multifaceted association between PTSD and diabetes, these patients need treatment that is an integrated approach to both conditions. The healthcare professional should be vigilant about how is diabetes secondary to PTSD as well as help address the mental as well as physical conditions of the patients. Some major strategies for their management include

• Therapy and Counseling: This is the treatment of PTSD where therapies such as Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR) can help process traumatic experiences, reducing the psychological symptoms of PTSD. Mental health issues must be addressed to enhance overall well-being and diabetes management.
• Stress Management Techniques: Teaching relaxation techniques, such as mindfulness, meditation, and deep breathing exercises, can help individuals with PTSD manage stress and reduce the impact of chronic cortisol elevation on blood sugar levels.
• Lifestyle Interventions: Healthy lifestyle approaches, including a regular exercise pattern, balanced nutrition, and quality sleep, have been shown to reduce the prevalence of obesity and insulin resistance; in addition, emotional eating can be addressed, and better relationships with food can be improved to enhance control over blood sugar levels.
• Integrated Care Approach: There is a need for collaboration between mental health professionals, endocrinologists, and other healthcare providers in the treatment of PTSD and diabetes. Integrated care ensures that both conditions are treated simultaneously, which leads to better outcomes.

The Link Between Diabetes and Complex PTSD

Diabetes, especially type 2, can develop in people with PTSD due to the body’s stress response. Chronic stress from PTSD raises cortisol levels, which can affect insulin and increase the risk of insulin resistance, leading to diabetes. Those with complex PTSD may also struggle with unhealthy habits like poor eating, lack of exercise, and bad sleep, which worsen diabetes risk. Additionally, emotional struggles can lead to overeating or substance use, further harming the body and increasing the chances of developing diabetes.

Know the 17 symptoms of complex PTSD in detail by clicking Here.

Role of PGx Testing in Managing PTSD and Preventing Diabetes Development

PGx testing, also known as pharmacogenomic testing, could prove to be of utmost importance in diagnosing and prescribing the most effective medications for people with PTSD before the condition leads to complications like diabetes. PGx tests examine an individual’s genetics so that the drug he or she will probably react to well can be decided, meaning that the healthcare provider shall give the most proper drugs with as minimal side effects as possible. For patients suffering from PTSD, such an approach would make the treatment more efficient, decrease levels of stress, and prevent them from developing a stress-related disorder like diabetes and, therefore, improve both psychological and physical conditions.

Conclusion

People suffering from PTSD experience many physiological and behavioural problems that raise their risk for Type 2 diabetes, including chronic stress, unhealthy coping mechanisms, disturbances in sleep, and low-grade inflammation. The existence of both conditions would have a greater impact on the health of the person, more mentally and physically, raising the risk of complications and poor outcomes. However, through integrated care that deals with the psychological and physical aspects of these conditions, there is a chance to improve the quality of life of individuals suffering from PTSD and diabetes.
The main strategies, such as therapy, stress management, healthy lifestyle modifications, and the use of PGx testing for personalized treatment, can help manage both PTSD and diabetes, offering a path toward better health and well-being. This way of treatment for the two diseases allows one to provide intensive care and will improve the patient’s situation.

References

https://www.nature.com/articles/s41598-023-28373-x
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822292
https://pmc.ncbi.nlm.nih.gov/articles/PMC4522929/

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