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The Link Between Adverse Childhood Experiences and Diabetes

  • Psychosocial Aspects (S Jaser and KK Hood, Section Editors)
  • Published:
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Abstract

Exposure to adversity in childhood (adverse childhood experiences [ACEs]) is linked to a number of chronic diseases in adulthood, yet there is limited research examining the impact of ACEs on diabetes. The current review sought to examine the association between ACEs, other trauma exposure or posttraumatic stress disorder (PTSD) diagnosis, and risk for diabetes. Thirty-eight studies are reviewed. Unlike in other diseases, several studies in diabetes show a threshold-response versus a dose-response relation, while other studies show a relation between greater abuse severity and diabetes risk. There were mixed results for studies examining abuse type and frequency. Chronic or comorbid PTSD was also related to increased diabetes risk among veterans, but in community samples, only trauma exposure predicted diabetes risk. While the research is still limited, diabetes researchers and clinicians should consider screening for ACEs and examine severity and frequency across abuse type as a predictor of both diabetes and poor diabetes outcomes.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14(4):245–58.

    Article  CAS  PubMed  Google Scholar 

  2. Kim‐Spoon J, Cicchetti D, Rogosch FA. A longitudinal study of emotion regulation, emotion lability‐negativity, and internalizing symptomatology in maltreated and nonmaltreated children. Child Dev. 2013;84(2):512–27.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ayoub CC, O’Connor E, Rappolt-Schlichtmann G, Fischer KW, Rogosch FA, Toth SL, et al. Cognitive and emotional differences in young maltreated children: a translational application of dynamic skill theory. Dev Psychopathol. 2006;18(03):679–706.

    Article  PubMed  Google Scholar 

  4. Miller GE, Chen E, Parker KJ. Psychological stress in childhood and susceptibility to the chronic diseases of aging: moving toward a model of behavioral and biological mechanisms. Psychol Bull. 2011;137(6):959–97.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gary-Webb TL, Suglia SF, Tehranifar P. Social epidemiology of diabetes and associated conditions. Curr Diabetes Rep. 2013;13(6):850–9.

    Article  Google Scholar 

  6. Turner HA, Ormond R, Hamby SL. Violence, crime, and abuse exposure in a national sample of children and youth: an update. JAMA Pediatr. 2013;167(7):614–21.

    Article  PubMed  Google Scholar 

  7. US Department of Health and Family Services. Child maltreatment. 2012; retrieved from http://www.acf.hhs.gov/sites/default/files/cb/cm2012.pdf.

  8. Burke NJ, Hellman JL, Scott BG, Weems CF, Carrion VG. The impact of adverse childhood experiences on an urban pediatric population. Child Abuse Negl. 2011;35(6):408–13.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Barnard KD, Skinner TC, Peveler R. The prevalence of co‐morbid depression in adults with Type 1 diabetes: systematic literature review. Diabet Med. 2006;23(4):445–8.

    Article  CAS  PubMed  Google Scholar 

  10. Lawrence JM, Standiford DA, Loots B, Klingensmith GJ, Williams DE, Ruggiero A, et al. SEARCH for diabetes in youth study. Pediatrics. 2006;117(4):1348–58.

    Article  PubMed  Google Scholar 

  11. Cooper MN, O’Connell SM, Davis EA, Jones TW. A population-based study of risk factors for severe hypoglycaemia in a contemporary cohort of childhood-onset type 1 diabetes. Diabetologia. 2013;56(10):2164–70.

    Article  PubMed  Google Scholar 

  12. Valenzuela JM, Seid M, Waitzfelder B, Anderson AM, Beavers DP, Dabelea DM. SEARCH for Diabetes in Youth Study Group. Prevalence of and disparities in barriers to care experienced by youth with type 1 diabetes. J Pediatr. 2014;164(6):1369–75.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Bellis MA, Hughes K, Leckenby N, Hardcastle KA, Perkins C, Lowey H. Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: a national survey. Journal of public health. 2014; 1–10. This paper has an important impact because it demonstrated a threshold effect for ACES and diabetes; the odds of diabetes were higher with at least 4 ACEs, and there was no dose-response relation.

  14. Almuneef M, Qayad M, Aleissa M, Albuhairan F. Adverse childhood experiences, chronic diseases, and risky health behaviors in Saudi Arabian adults: a pilot study. Child Abuse Negl. 2014;38(11):1787–93.

    Article  PubMed  Google Scholar 

  15. Scott KM, Von Korff M, Angermeyer MC, Benjet C, Bruffaerts R, De Girolamo G, et al. Association of childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions. Arch Gen Psychiatry. 2011;68(8):838–44.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gilbert LK, Breiding MJ, Merrick MT, Thompson WW, Ford DC, Dhingra SS, et al. Childhood adversity and adult chronic disease: an update from ten states and the District of Columbia. Am J Prev Med. 2015;48(3):345–9. This paper is of importance because it demonstrated that 1–3 or 4–6 ACEs, but not 7–9 ACEs, increased the odds of diabetes, which is contrary to previous ACE studies.

    Article  PubMed  Google Scholar 

  17. Husarewycz MN, El-Gabalawy R, Logsetty S, Sareen J. The association between number and type of traumatic life experiences and physical conditions in a nationally representative sample. Gen Hosp Psychiatry. 2014;36(1):26–32. This paper is important given that it was one of the few that adjusted for numerous covariates, included a large number of adverse events, and found that both adversity type and exposure to cumulative events resulted in greater odds of diabetes.

    Article  PubMed  Google Scholar 

  18. Karavanaki K, Tsoka E, Liacopoulou M, Karayianni C, Petrou V, Pippidou E, et al. Psychological stress as a factor potentially contributing to the pathogenesis of type 1 diabetes mellitus. J Endocrinol Investig. 2008;31(5):406–15.

    Article  CAS  Google Scholar 

  19. Roy A, Janal MN, Roy M. Childhood trauma and prevalence of cardiovascular disease in patients with type 1 diabetes. Psychosom Med. 2010;72(8):833–8.

    Article  PubMed  Google Scholar 

  20. Lynch L, Waite R, Davey MP. Adverse childhood experiences and diabetes in adulthood: support for a collaborative approach to primary care. Contemp Fam Ther. 2013;35(4):639–55. This paper was significant for the field given that it was one of the first to establish a relation between ACEs and T2DM. Specifically, with every 1 point increase in ACE score, patients had 11% greater likelihood of T2DM.

    Article  Google Scholar 

  21. Danese A, Tan M. Childhood maltreatment and obesity: systematic review and meta-analysis. Mol Psychiatry. 2014;19(5):544–54.

    Article  CAS  PubMed  Google Scholar 

  22. Kendall-Tackett KA, Marshall R. Victimization and diabetes: an exploratory study. Child Abuse Negl. 1999;23(6):593–6.

    Article  CAS  PubMed  Google Scholar 

  23. Widom CS, Czaja SJ, Bentley T, Johnson MS. A prospective investigation of physical health outcomes in abused and neglected children: new findings from a 30-year follow-up. Am J Public Health. 2012;102(6):1135–44.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Goodwin RD, Weisberg SP. Childhood abuse and diabetes in the community. Diabetes Care. 2002;25(4):801–2.

    Article  PubMed  Google Scholar 

  25. Zung A, Blumenfeld O, Shehadeh N, Dally Gottfried O, Tenenbaum Rakover Y, Hershkovitz E, et al. Increase in the incidence of type 1 diabetes in Israeli children following the Second Lebanon War. Pediatr Diabetes. 2012;13(4):326–33.

    Article  PubMed  Google Scholar 

  26. Vlajinac H, Šipetić S, Marinković J, Bjekić M, Kocev N, Sajić S. The Belgrade childhood diabetes study–comparison of children with type 1 diabetes with their siblings. Paediatr Perinat Epidemiol. 2006;20(3):238–43.

    Article  PubMed  Google Scholar 

  27. Sipetic S, Vlajinac H, Marinkovi J, Kocev N, Milan B, Ratkov I, et al. Stressful life events and psychological dysfunctions before the onset of type 1 diabetes mellitus. J Pediatr Endocrinol Metab. 2007;20(4):527–34.

    Article  PubMed  Google Scholar 

  28. Goodwin RD, Stein MB. Association between childhood trauma and physical disorders among adults in the United States. Psychol Med. 2004;34(03):509–20.

    Article  PubMed  Google Scholar 

  29. Shaw BA, Krause N. Exposure to physical violence during childhood, aging, and health. J Aging Health. 2002;14(4):467–94.

    Article  PubMed  Google Scholar 

  30. Thomas C, Hyppönen E. Power C Obesity and type 2 diabetes risk in midadult life: the role of childhood adversity. Pediatrics. 2008;121(5):e1240–9.

    Article  PubMed  Google Scholar 

  31. Norman SB, Means‐Christensen AJ, Craske MG, Sherbourne CD, Roy‐Byrne PP, Stein MB. Associations between psychological trauma and physical illness in primary care. J Trauma Stress. 2006;19(4):461–70.

    Article  PubMed  Google Scholar 

  32. Romans S, Belaise C, Martin J, Morris E, Raffi A. Childhood abuse and later medical disorders in women. Psychother Psychosom. 2002;71(3):141–50.

    Article  PubMed  Google Scholar 

  33. Rich-Edwards JW, Spiegelman D, Hibert ENL, Jun HJ, Todd TJ, Kawachi I, et al. Abuse in childhood and adolescence as a predictor of type 2 diabetes in adult women. Am J Prev Med. 2010;39(6):529–36.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Duncan AE, Auslander WF, Bucholz KK, et al. Relationship between abuse and neglect in childhood and diabetes in adulthood: differential effects by sex, National Longitudinal Study of Adolescent Health. Prev Chron Dis. 2015;12(E70):1–14. This paper was important in providing evidence for a threshold effect, given that greater odds of diabetes were only evident for men who were sexually abused three or more times.

  35. Brewin CR, Andrews B. Valentine JD Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000;68:748–66.

    Article  CAS  PubMed  Google Scholar 

  36. Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull. 2003;129:52–73.

    Article  PubMed  Google Scholar 

  37. Dedert EA, Calhoun PS, Watkins LL, Sherwood A, Beckham JC. Posttraumatic stress disorder, cardiovascular, and metabolic disease: a review of the evidence. Ann Behav Med. 2010;39:61–78.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Pacella ML, Hruska B, Delahanty DL. The physical health consequences of PTSD and PTSD symptoms: a meta-analytic review. J Anxiety Disord. 2013;27:33–46.

    Article  PubMed  Google Scholar 

  39. Friedman MJ, McEwen BS. Posttraumatic stress disorder, allostatic load, and medical illness. In: Schnurr PP, Green BL, editors. Trauma and health: physical health consequences of exposure to extreme stress. Washington: American Psychological Association; 2004. p. 157–88.

    Chapter  Google Scholar 

  40. Boscarino JA. Posttraumatic stress disorder and physical illness: results from clinical and epidemiologic studies. Ann N Y Acad Sci. 2004;1032(1):141–53.

    Article  PubMed  Google Scholar 

  41. Boyko EJ, Seelig AD, Jacobson IG, Hooper TI, Smith B, Smith TC. Millennium Cohort Study Team. Sleep Characteristics, Mental Health, and Diabetes Risk A prospective study of US military service members in the Millennium Cohort Study. Diabetes Care. 2013;36(10):3154–61.

    Article  PubMed  PubMed Central  Google Scholar 

  42. David D, Woodward C, Esquenazi J, Mellman TA. Comparison of comorbid physical illnesses among veterans with PTSD and veterans with alcohol dependence. Psychiatr Serv. 2004;55(1):82–5.

    Article  PubMed  Google Scholar 

  43. Trief PM, Ouimette P, Wade M, Shanahan P, Weinstock RS. Post-traumatic stress disorder and diabetes: co-morbidity and outcomes in a male veterans sample. J Behav Med. 2006;29(5):411–8.

    Article  PubMed  Google Scholar 

  44. Vaccarino V, Goldberg J, Magruder KM, Forsberg CW, Friedman MJ, Litz BT, et al. Posttraumatic stress disorder and incidence of type-2 diabetes: a prospective twin study. J Psychiatr Res. 2014;56:158–64.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Boyko EJ, Jacobson IG, Smith B, Ryan MA, Hooper TI, Amoroso PJ. Millennium Cohort Study Team. Risk of diabetes in US military service members in relation to combat deployment and mental health. Diabetes Care. 2010;36:3154–61.

    Article  Google Scholar 

  46. Lukaschek K, Baumert J, Kruse J, Emeny RT, Lacruz ME, Huth C, et al. Relationship between posttraumatic stress disorder and type 2 diabetes in a population-based cross-sectional study with 2970 participants. J Psychosom Res. 2013;74(4):340–5.

    Article  PubMed  Google Scholar 

  47. Rao MN, Chau A, Madden E, Inslicht S, Talbot L, Richards A, et al. Hyperinsulinemic response to oral glucose challenge in individuals with posttraumatic stress disorder. Psychoneuroendocrinology. 2014;49:171–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Goodwin RD, Davidson JR. Self-reported diabetes and posttraumatic stress disorder among adults in the community. Prev Med. 2005;40(5):570–4.

    Article  PubMed  Google Scholar 

  49. Miller-Archie SA, Jordan HT, Ruff RR, Chamany S, Cone JE, Brackbill RM, et al. Posttraumatic stress disorder and new-onset diabetes among adult survivors of the World Trade Center disaster. Prev Med. 2014;66:34–8.

    Article  PubMed  Google Scholar 

  50. Pietrzak RH, Goldstein RB, Southwick SM, Grant BF. Medical comorbidity of full and partial posttraumatic stress disorder in United States adults: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosom Med. 2011;73(8):697–707.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Weisberg RB, Bruce SE, Machan JT, Kessler RC, Culpepper L, Keller MB. Nonpsychiatric illness among primary care patients with trauma histories and posttraumatic stress disorder. Psychiatr Serv. 2014;53(7):848–54.

    Article  Google Scholar 

  52. Miller SA, Mancuso CA, Boutin-Foster C, Michelen W, McLean-Long C, Foote B. Charlson ME associations between posttraumatic stress disorder and hemoglobin A1 C in low-income minority patients with diabetes. Gen Hosp Psychiatry. 2011;33:116–22.

    Article  PubMed  Google Scholar 

  53. Wagner J, Burke G, Kuoch T, Scully M, Armeli S, Rajan TV. Trauma, healthcare access, and health outcomes among Southeast Asian refugees in Connecticut. J Immigr Minor Health. 2013;15(6):1065–72.

    Article  PubMed  Google Scholar 

  54. Roberts AL, Agnew-Blais JC, Spiegelman D, Kubzansky LD, Mason SM, Galea S, et al. Posttraumatic stress disorder and incidence of type 2 diabetes mellitus in a sample of women: a 22-year longitudinal study. JAMA Psychiatry. 2015;72(3):203–10.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Agyemang C, Goosen S, Anujuo K, Ogedegbe G. Relationship between post-traumatic stress disorder and diabetes among 105,180 asylum seekers in the Netherlands. Eur J Public Health. 2011;22(5):658–62.

    Article  PubMed  Google Scholar 

  56. Layne CM, Greeson JKP, Ostrowski SA, Kim S, Reading S, Vivrette RL, et al. Cumulative trauma exposure and high risk behavior in adolescence: findings from the National Child Traumatic Stress Network Core Data Set. Psychol Trauma Theory, Res, Pract, Policy. 2014;6:S40–9.

    Article  Google Scholar 

  57. Jackson Y, Gabrielli J, Fleming K, Tunno AM, Makanui PK. Untangling the relative contribution of maltreatment severity and frequency to type of behavioral outcome in foster youth. Child Abuse Negl. 2014;38(7):1147–59.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Shenk CE, Putnam FW, Rausch JR, Peugh JL, Noll JG. A longitudinal study of several potential mediators of the relationship between child maltreatment and posttraumatic stress disorder symptoms. Dev Psychopathol. 2014;26(01):81–91.

    Article  PubMed  Google Scholar 

  59. Collishaw S, Pickles A, Messer J, Rutter M, Shearer C, Maughan B. Resilience to adult psychopathology following childhood maltreatment: evidence from a community sample. Child Abuse Negl. 2007;31(3):211–29.

    Article  PubMed  Google Scholar 

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Correspondence to Susana R. Patton.

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Lindsay Huffhines, Amy Noser, and Susana R. Patton declare that they have no conflict of interest.

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Huffhines, L., Noser, A. & Patton, S.R. The Link Between Adverse Childhood Experiences and Diabetes. Curr Diab Rep 16, 54 (2016). https://doi.org/10.1007/s11892-016-0740-8

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