July 27, 2019

PTSD is a chronic condition that affects up to 12% of civilians and up to 30% of the veteran population.

PTSD is associated with increased rates of type 2 diabetes, obesity, glucose dysregulation, inflammation, metabolic syndrome, and depression.

This retrospective analysis of VA records from 2008 to 2015 identified 1,598 patients with PTSD and free of diabetes. They compared those with symptom improvement against those without symptom improvement.

They reported that successful treatment for PTSD (improvement in symptoms) was associated with a 49% lower risk of being diagnosed with type 2 diabetes, over a 3-6-year follow-up period. Therefore, successful PTSD treatment was associated with a reduced risk of developing type 2 diabetes.

I Interpret the data another way: Patients who were prevented from becoming diabetic had improved PTSD symptoms. The reason I say this is that the start HgBA1C was 5.5, they were borderline insulin resistant to start with.

Patients who make lifestyle alterations to improve insulin sensitivity result in lowered depression, anxiety, pain, and PTSD. • It could be that the Enteric Nervous System is affected, resulting in reduced metainflammation and improved vagal tone. • We know that improved vagal tone using stellate blockade improves PTSD symptoms, primarily by increasing HRV and decreasing sympathetic tone. • We also know that the majority of the human bodies serotonin neurotransmitters, the target of SSRI medications, also resides in the Enteric Nervous System.

Association Between Clinically Meaningful Posttraumatic Stress Disorder Improvement and Risk of Type 2 Diabetes. JAMA Psychiatry, 2019

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