Female patients with post-traumatic stress disorder are nearly twice as likely to develop type 2 diabetes compared with female patients who don’t have post-traumatic stress disorder, according to research published in JAMA Psychiatry.

“Not only is post-traumatic stress disorder (PTSD) devastating to mental health, but it affects physical health too, raising risk for cardiovascular disease, diabetes, and obesity,” said Karestan C. Koenen, PhD, of Columbia University in New York City, N.Y., in a university press release.

To examine the association between PTSD symptoms and type 2 diabetes incidence, the investigators collected data from a U.S. longitudinal cohort of women (n=49,739) over a 22-year follow-up period.

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Type 2 diabetes was confirmed using a survey method that first asked the female patients whether they had been diagnosed by a doctor, information about test results, symptoms, and medications. PTSD was assessed using the Short Screening Scale. The participants reported trauma including sexual assault, domestic violence, car accidents, and unexpected death of a loved one.

Symptoms of PTSD were associated in a dose-response fashion with type 2 diabetes incidence, found the study authors. The greater the number and severity of PTSD symptoms, the greater a patient’s risk of type 2 diabetes.

By age 60 years, nearly 12% of the study participants with the highest number of PTSD symptoms had developed type 2 diabetes, whereas fewer than 7% of women with no trauma exposure had diabetes.

“Health professionals treating women with PTSD should be aware that these patients are at risk of increased body mass index and type 2 diabetes,” concluded the researchers.

“Comprehensive PTSD treatment should be expanded to address the health behaviors that contribute to obesity and chronic disease in affected populations. “