Posttraumatic stress disorder and diabetes-related outcomes in patients with type 1 diabetes
Abstract Mental comorbidities in patients with type 1 diabetes mellitus (T1D) are common, and can have a negative impact on acute blood glucose levels and long-term metabolic control. Information on the association of T1D and comorbid posttraumatic stress disorder (PTSD) with diabetes-related outcom...
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Nature Portfolio
2023-01-01
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Series: | Scientific Reports |
Online Access: | https://doi.org/10.1038/s41598-023-28373-x |
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author | Frederike Lunkenheimer Alexander J. Eckert Dörte Hilgard Daniel Köth Bernhard Kulzer Ursula Lück Blanca Lüdecke Antonia Müller Harald Baumeister Reinhard W. Holl |
author_facet | Frederike Lunkenheimer Alexander J. Eckert Dörte Hilgard Daniel Köth Bernhard Kulzer Ursula Lück Blanca Lüdecke Antonia Müller Harald Baumeister Reinhard W. Holl |
author_sort | Frederike Lunkenheimer |
collection | DOAJ |
description | Abstract Mental comorbidities in patients with type 1 diabetes mellitus (T1D) are common, and can have a negative impact on acute blood glucose levels and long-term metabolic control. Information on the association of T1D and comorbid posttraumatic stress disorder (PTSD) with diabetes-related outcomes is limited. The aim was to examine the associations between a clinical diagnosis of PTSD and diabetes-related outcomes in patients with T1D. Patients with T1D and comorbid documented PTSD from the DPV database (n = 179) were compared to a group with T1D without PTSD (n = 895), and compared to a group with T1D without comorbid mental disorder (n = 895) by matching demographics (age, gender, duration of diabetes, therapy and migration background) 1:5. Clinical diabetes-related outcomes {body mass index (BMI), hemoglobin A1c (hbA1c), daily insulin dose, diabetic ketoacidosis (DKA), hypoglycemia, number of hospital admissions, number of hospital days} were analyzed, stratified by age groups (≤ 25 years vs. > 25 years). Patients with comorbid PTSD aged ≤ 25 years compared with patients without PTSD or patients without mental disorders had significantly higher HbA1c (8.71 vs. 8.30 or 8.24%), higher number of hospital admissions (0.94 vs. 0.44 or 0.32 per year) and higher rates of DKA (0.10 vs. 0.02 or 0.01 events/year). Patients with comorbid PTSD aged ≤ 25 years compared with patients without PTSD had significantly higher BMI (0.85 vs. 0.59) and longer hospital stays (15.89 vs.11.58 days) than patients without PTSD. Patients with PTSD > 25 years compared with patients without PTSD or without any mental comorbidities had significantly fewer hospital admissions (0.49 vs. 0.77 or 0.69), but a longer hospital length of stay (20.35 vs. 11.58 or 1.09 days). We found that PTSD in younger patients with T1D is significantly related to diabetes outcome. In adult patients with T1D, comorbid PTSD is associated with fewer, but longer hospitalizations. Awareness of PTSD in the care of patients with T1D should be raised and psychological intervention should be provided when necessary. |
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institution | Directory Open Access Journal |
issn | 2045-2322 |
language | English |
last_indexed | 2024-04-10T19:44:43Z |
publishDate | 2023-01-01 |
publisher | Nature Portfolio |
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spelling | doaj.art-e8868653d8304e40b180a66bd576eb862023-01-29T12:08:55ZengNature PortfolioScientific Reports2045-23222023-01-0113111110.1038/s41598-023-28373-xPosttraumatic stress disorder and diabetes-related outcomes in patients with type 1 diabetesFrederike Lunkenheimer0Alexander J. Eckert1Dörte Hilgard2Daniel Köth3Bernhard Kulzer4Ursula Lück5Blanca Lüdecke6Antonia Müller7Harald Baumeister8Reinhard W. Holl9Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm UniversityInstitute of Epidemiology and Medical Biometry, ZIBMT, Ulm UniversityPediatric Endocrinology and Diabetology, Primary Psychosomatic CareDepartment of Endocrinology and Diabetology, Hospital SachsenhausenGerman Center for Diabetes Research (DZD)Department of Pediatrics and Adolescent Medicine, Regional Hospital MödlingDiabetes Centre, Alexianer St. Hedwig HospitalClinic Group Dr. Guth GmbH & Co. KG, Clinical Center KarlsburgDepartment of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm UniversityInstitute of Epidemiology and Medical Biometry, ZIBMT, Ulm UniversityAbstract Mental comorbidities in patients with type 1 diabetes mellitus (T1D) are common, and can have a negative impact on acute blood glucose levels and long-term metabolic control. Information on the association of T1D and comorbid posttraumatic stress disorder (PTSD) with diabetes-related outcomes is limited. The aim was to examine the associations between a clinical diagnosis of PTSD and diabetes-related outcomes in patients with T1D. Patients with T1D and comorbid documented PTSD from the DPV database (n = 179) were compared to a group with T1D without PTSD (n = 895), and compared to a group with T1D without comorbid mental disorder (n = 895) by matching demographics (age, gender, duration of diabetes, therapy and migration background) 1:5. Clinical diabetes-related outcomes {body mass index (BMI), hemoglobin A1c (hbA1c), daily insulin dose, diabetic ketoacidosis (DKA), hypoglycemia, number of hospital admissions, number of hospital days} were analyzed, stratified by age groups (≤ 25 years vs. > 25 years). Patients with comorbid PTSD aged ≤ 25 years compared with patients without PTSD or patients without mental disorders had significantly higher HbA1c (8.71 vs. 8.30 or 8.24%), higher number of hospital admissions (0.94 vs. 0.44 or 0.32 per year) and higher rates of DKA (0.10 vs. 0.02 or 0.01 events/year). Patients with comorbid PTSD aged ≤ 25 years compared with patients without PTSD had significantly higher BMI (0.85 vs. 0.59) and longer hospital stays (15.89 vs.11.58 days) than patients without PTSD. Patients with PTSD > 25 years compared with patients without PTSD or without any mental comorbidities had significantly fewer hospital admissions (0.49 vs. 0.77 or 0.69), but a longer hospital length of stay (20.35 vs. 11.58 or 1.09 days). We found that PTSD in younger patients with T1D is significantly related to diabetes outcome. In adult patients with T1D, comorbid PTSD is associated with fewer, but longer hospitalizations. Awareness of PTSD in the care of patients with T1D should be raised and psychological intervention should be provided when necessary.https://doi.org/10.1038/s41598-023-28373-x |
spellingShingle | Frederike Lunkenheimer Alexander J. Eckert Dörte Hilgard Daniel Köth Bernhard Kulzer Ursula Lück Blanca Lüdecke Antonia Müller Harald Baumeister Reinhard W. Holl Posttraumatic stress disorder and diabetes-related outcomes in patients with type 1 diabetes Scientific Reports |
title | Posttraumatic stress disorder and diabetes-related outcomes in patients with type 1 diabetes |
title_full | Posttraumatic stress disorder and diabetes-related outcomes in patients with type 1 diabetes |
title_fullStr | Posttraumatic stress disorder and diabetes-related outcomes in patients with type 1 diabetes |
title_full_unstemmed | Posttraumatic stress disorder and diabetes-related outcomes in patients with type 1 diabetes |
title_short | Posttraumatic stress disorder and diabetes-related outcomes in patients with type 1 diabetes |
title_sort | posttraumatic stress disorder and diabetes related outcomes in patients with type 1 diabetes |
url | https://doi.org/10.1038/s41598-023-28373-x |
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