Posttraumatic Stress Disorder and Type 2 Diabetes Outcomes in Veterans
Main finding · Microvascular complications (after controlling for confounding)Result — go to the resultHazard ratio 0.92 95% CI 0.85–0.99Authors' conclusion
The findings of this cohort study of patients with comorbid PTSD and T2D suggest that PTSD is a modifiable risk factor associated with a modest reduction in microvascular complications. Further research is needed to determine whether findings are similar in non-VHA health care settings.
Study context
- Population
- US veterans aged 18 to 80 years with comorbid posttraumatic stress disorder (PTSD) and T2D, Veterans Health Administration records (October 1, 2011, to September 30, 2022); 65.3% aged >50 years, 87.2% men
- Participants
- 10,002 veterans
- Exposure
- No longer meeting PTSD criteria vs persistent PTSD
- Outcome
- Insulin initiation, poor glycemic control, any microvascular complication and all-cause mortality
Methodological detailsentropy balancing, survival and competing risk models
- Entropy balancing
- Survival and competing risk models
Main finding
As reported in the abstract
Microvascular complications (after controlling for confounding)
Hazard ratio
0.92
95% CI 0.85–0.99
PTSD improvedvs Persistent PTSD
HR 0.92 (95% CI 0.85–0.99)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Insulin initiation, veterans aged 18 to 49 years | 0.69 (0.53–0.88) | |
| All-cause mortality, veterans aged 18 to 49 years | 0.39 (0.19–0.83) | |
| Insulin initiation, patients without depression | 0.73 (0.55–0.97) | |
| 0.20.5125Hazard ratio (log scale) |
Unadjusted incidence rates (before entropy balancing)
- Starting insulin, PTSD improved vs persistent PTSD
- 22.4 vs 24.4 per 1000 person-years
- Poor glycemic control, PTSD improved vs persistent PTSD
- 137.1 vs 133.7 per 1000 person-years
- Any microvascular complication, PTSD improved vs persistent PTSD
- 108.4 vs 104.8 per 1000 person-years
- All-cause mortality, PTSD improved vs persistent PTSD
- 11.2 vs 11.0 per 1000 person-years
- Similar incidence rates
Original publication
Posttraumatic Stress Disorder and Type 2 Diabetes Outcomes in Veterans. JAMA Netw Open. Published 1 August 2024. doi:10.
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