Jaime Herndon is a freelance health/medical writer with over a decade of experience writing for the public.
Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Post-traumatic stress disorder (PTSD) is a mental disorder that is a result of exposure to certain terrifying or life-threatening (actual or perceived) events. It can cause emotional and physical dysregulation in a variety of ways.
Type 2 diabetes is a form of diabetes where the cells don’t respond properly to insulin (a hormone that regulates blood sugar), resulting in elevated blood glucose (blood sugar).
While the two conditions may seem unrelated, there is an association between them. PTSD has been linked to poor diet, inflammation, and reduced physical activity, which are also risk factors for type 2 diabetes.
In this article, we review the connection between PTSD and type 2 diabetes and how one condition may impact the diagnosis and treatment of the other condition.
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PTSD has been associated with an increased risk of type 2 diabetes. This is partially because of the higher prevalence of inflammation, obesity, metabolic syndrome, and depression among those with PTSD compared to those without PTSD.
Lack of physical activity due to psychiatric factors such as depression or anxiety associated with PTSD can also lead to becoming overweight or obese, increasing the risk of type 2 diabetes.
Certain medications for PTSD, like some antidepressants and antipsychotics, can also cause weight gain or problems with glucose regulation, which can increase the risk of developing type 2 diabetes.
Improvements in PTSD symptoms have been associated with reduced type 2 diabetes risk. Decreased depression, as well as adherence to taking selective serotonin reuptake inhibitors (SSRIs), has been associated with improvements in insulin resistance, blood glucose control, and reduced inflammation.
This may be to some degree because once someone is not experiencing a depressed mood, they are more likely to be physically active, eat a healthier diet, and connect with others for social support and activities.
A 2019 study found that after controlling for confounding variables, obesity was still a major factor in whether someone with PTSD would develop type 2 diabetes. In those living with PTSD, ensuring that they are eating healthy diets and staying physically active is important for their mental and physical health.
PTSD, when not treated or managed, can increase unhealthy lifestyle behaviors like self-medicating with food, substances, or smoking. This can increase the risk of obesity, high blood pressure, and cardiovascular diseases.
Go to the emergency room or call 911 if you have:
Call a healthcare provider if you have:
PTSD and type 2 diabetes have very different symptoms and are diagnosed by two different kinds of healthcare professionals. Mental health disorders are diagnosed according to criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A psychologist or psychiatrist typically diagnoses PTSD.
Criteria for PTSD can include:
Type 2 diabetes can be diagnosed by your primary healthcare provider or an endocrinologist (a physician specializing in hormonal health conditions).
Healthcare professionals should be aware of the link between PTSD and type 2 diabetes, particularly symptoms like physical inactivity, obesity, and side effects of certain psychiatric medications (like weight gain).
If you think you might have PTSD, there are some online screening tools like:
It’s important to remember that these are merely screening tools for oneself, and a clinical diagnosis needs to be made by a mental healthcare professional.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 and connect with a trained counselor. If you or a loved one are in immediate danger, call 911.
Type 2 diabetes is generally treated by healthy eating, exercise, and medications, which may sometimes include insulin. Stress can also affect blood sugar levels, so stress management is often encouraged in managing diabetes.
PTSD is often treated with psychotherapy and sometimes medications if need be. PTSD may affect the treatment of type 2 diabetes by impacting stress levels and mental health.
PTSD can be treated with several medications, including selective serotonin reuptake inhibitors (SSRIs) like Zoloft (sertraline) or serotonin-norepinephrine reuptake inhibitors (SNRIs) like Effexor (venlafaxine) and other categories of psychiatric medications.
One study found that SSRIs improved blood sugar levels, but more research is necessary. Talk with your healthcare provider about the medications you are on for PTSD and how they may affect your blood sugar. This can also include side effects like weight gain and what that might mean for your blood sugar.
Medication may be given for type 2 diabetes if blood sugar levels are not controlled by lifestyle modifications such as diet and exercise. These may be oral or injectable medications.
Glucophage (metformin) is a first-line medication for the treatment of type 2 diabetes. A study of veterans with PTSD and diabetes who were given metformin after their PTSD diagnosis showed they were more likely to have a clinically meaningful reduction in PTSD symptoms than a control group not given metformin.
Four types of therapy are most strongly recommended for the treatment of PTSD, according to the American Psychological Association (APA):
Living with chronic health conditions, both mental and physical ones, can be challenging. It’s important to have coping tools to effectively manage these conditions and stay as healthy as possible.
Changing your lifestyle can help make symptoms of both PTSD and type 2 diabetes more manageable and improve your health, but getting treatment from healthcare providers and mental healthcare professionals is still necessary for the best outcome.
Lifestyle changes that can be beneficial include:
Ask your healthcare provider about support groups in your area. There may be support groups for either PTSD or diabetes at hospitals, outpatient treatment centers, therapy practices, or medical offices. Your healthcare provider may know of these and be able to put you in contact with them.
For PTSD, support groups can be helpful, including:
Diabetes support groups include:
PTSD and type 2 diabetes may seem like two unrelated conditions, but research shows there are associations between the two.
Living with PTSD increases the risk of developing type 2 diabetes, likely because of factors like lack of physical activity, obesity, inflammatory processes in the body, and certain medications that may be used to treat PTSD (although others can help glucose levels).
While there are ways to manage both with lifestyle changes, seeing healthcare providers for both conditions is necessary.
If you have PTSD and type 2 diabetes, talk with both the healthcare provider and mental healthcare professional treating your conditions about how the two affect each other. If need be, have the two healthcare providers connect and discuss a joint plan of care to help you stay as healthy as possible.
The association between the two conditions appears to be related to the high prevalence of obesity, problems with glucose regulation, inflammation, metabolic syndrome, and the impact of associated conditions like depression in those with PTSD.
Yes, multiple studies have shown this. Improvements in PTSD symptoms have also been associated with decreased risks of developing type 2 diabetes. Treating PTSD can also reduce inflammation in the body, high blood pressure, and other associated physical symptoms.
PTSD can also cause physical symptoms like joint pain, nausea, muscle tension, increased heart rate, headaches, back pain, fatigue, and other kinds of pain. Some people with PTSD and chronic pain may also misuse substances like alcohol or prescription medications to self-medicate.
Scherrer JF, Salas J, Norman SB, et al. Association between clinically meaningful posttraumatic stress disorder improvement and risk of type 2 diabetes. JAMA Psychiatry. 2019;76(11):1159-1166. doi:10.1001/jamapsychiatry.2019.2096
Scherrer JF, Lustman PJ. Posttraumatic stress disorder and incident type 2 diabetes: is obesity to blame? Chronic Stress. 2019;3:1-3. doi:10.1177/2470547019863415
Department of Veterans Affairs. Medications for PTSD.
Tharmaraja T, Stahl D, Hopkins CWP, et al. The association between selective serotonin reuptake inhibitors and glycemia: a systematic review and meta-analysis of randomized controlled trials. Psychosomatic Medicine. 2019;81(7):570-583. doi:10.1097/PSY.0000000000000707
Liu S, Raines AM, Yoshida Y, et al. 174-lb: association between metformin treatment and improved symptoms of post-traumatic stress disorder. Diabetes. 2020;69(Supplement_1):174-LB. doi:10.2337/db20-174-LB
American Psychological Association. PTSD treatments.
American Diabetes Association. 5. Facilitating behavior change and well-being to improve health outcomes: standards of medical care in diabetes—2022. Diabetes Care. 2022;45(Supplement 1):S60–S82. doi:10.2337/dc22-S005
Harp JB, Yancopoulos GD, Gromada J. Glucagon orchestrates stress‐induced hyperglycaemia. Diabetes Obes Metab. 2016;18(7):648-653. doi:10.1111/dom.12668
Evert AB, Dennison M, Gardner CD, et al. Nutrition therapy for adults with diabetes or prediabetes: a consensus report. Diabetes Care. 2019;42(5):731–754. doi:10.2337/dci19-0014
American Psychiatric Association. Expert Q&A: posttraumatic stress disorder (PTSD).
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