Post Traumatic Type 1 Diabetes Mellitus (insulin-dependent): A Case Report
Post traumatic type 1 diabetes mellitus (insulin-dependent): a case report 1Psychiatrist, Department of Psychiatry, Hopital Militaire Moulay Ismail, Mekns 50000, Morocco &Corresponding author: Rabie Karrouri, Psychiatrist, Department of Psychiatry, Hopital Militaire Moulay Ismail, Mekns 50000, Morocco Received 2014 Oct 18; Accepted 2014 Nov 19. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Most researchers have studied the influence of life stress as precipitating the onset of type 1 diabetes, but as the relationship between severe psychological trauma and diabetes has been a rarely studied subject in paediatric age group. Here, we report the case of a 10-year-old Libyan boy, without personal or familial diabetes mellitus history, which is presented to Moroccan medico-surgical field hospital, installed in Tunisia for refugees of the Libyan revolution, for type 1 diabetes appeared immediately after severe psychological trauma. Keywords: Trauma, diabetes, stress, pathogenesis, children In Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, trauma is described as the experience of intense fear, helplessness, horror, or disorganized and agitated behaviour in response to exposure to an event -directly or as a witness- that caused or threatened serious injury or violation of body integrity [ 1 ]. Type1-diabetes (T1D) or insulin-dependent diabetes or juvenile-onset diabetes is a chronic autoimmune disease characterized by the destruction of pancreatic -cells in the islets of Langerhans resulting in insulin deficiency and hyperglyca Continue reading >>
Can Stress Cause Type 2 Diabetes?
The idea that stress can cause type 2 diabetes is not new but recent media coverage of Dave Dowdeswell from the UK who, along with his doctors, believe the only explanation for his diabetes is extreme stress, has prompted discussion around this idea as another possible explanation for why many fit and otherwise healthy people can develop type 2 diabetes. At 44 Mr Dowdeswell, a keen windsurfer and diver, was not overweight and had no family history of diabetes. However, in the 12 months prior to his diagnosis of type 2 diabetes he had experienced a series of traumatic life events. His doctors believe the extreme stress he lived through could have been the trigger for diabetes. One theory is that the stress hormone cortisol may alter the body’s sensitivity to insulin. While scientists are not in agreement over whether this means stress itself is a direct cause of diabetes or just a risk factor, there are some compelling arguments and research is continuing in this area. A recent contribution to the debate comes from research funded by the Department of Defense in the US that find links between post traumatic stress disorder (PTSD) in soldiers returning from Iraq and Afghanistan and an increase in type 2 diabetes, hypertension and obesity. The study is still in its preliminary stages and other factors are being investigated as to why some people develop PTSD in the first place (such as stress response genetics) but initial findings make a definite link between war-related stress and depression on poor general health outcomes. In 2013 a 35 year prospective follow-up study of 7,500 middle-aged men in Sweden found a strong link between stress and diabetes risk. Levels of stress were graded by the participants and it was found that men who reported permanent stress had a 45% Continue reading >>
Early Trauma ‘triples’ Risk Of Type 1 Diabetes
A traumatic event during childhood can triple the risk of subsequently developing Type 1 diabetes, researchers have concluded. A new study from Sweden published in Diabetologia (the journal of the European Association for the Study of Diabetes) showed ‘serious life events’ in childhood, such as death or illness in the family, divorce or separation, a new child or adult in the family or conflicts in the family increase the chances of getting the condition. The causes of Type 1 diabetes are unknown but it is usually preceded by the body’s own immune system attacking and killing the beta cells in the pancreas that produce insulin. As well as genetic predisposition, several environmental factors such as viral infection, dietary habits in infancy, birthweight and early weight gain, as well as chronic stress, have been proposed as risk factors. Since the incidence of Type 1 diabetes among young children is increasing in most countries in the world, environmental factors are now being examined even more seriously. The study aimed to examine whether psychological stress in terms of experiences of ‘serious life events’, along with parental perception of parenting stress and lack of social support, during the child’s first 14 years of life, was a risk factor for developing Type 1 diabetes. The study invited all families with babies born between October 1997 and September 1999 in southeast Sweden to participate, with 10,495 families participating in at least one of four data collections carried out when the children were between 2 and 14 years. To be included in the study, the child must not have been diagnosed with Type 1 diabetes when participating for the first time. A total of 58 children were subsequently diagnosed with the condition. The authors found that childh Continue reading >>
Childhood Trauma May Raise Risk Of Type 1 Diabetes
(Reuters Health) - Traumatic events during childhood may increase kids’ risk of developing type 1 diabetes, a Swedish study suggests. The researchers questioned more than 10,000 families and found that children who experienced an extremely stressful life event – like divorce, illness or death in the family – were about three times more likely to develop type 1 diabetes. The link doesn’t prove trauma causes diabetes, but it does raise the possibility that mental health care or stress reduction could play a role in prevention, researchers said. “We know that there are connections between the brain and immune system, and it is not surprising that psychological trauma can influence the immune balance and contribute to abnormal reactions” including the development of type 1 diabetes, study coauthor Dr. Johnny Ludvigsson, a pediatrics researcher at Linkoping University in Sweden, said by email. Type 1 diabetes is an autoimmune disease in which the pancreas stops making insulin, a hormone that helps cells use sugar for energy. When the immune system attacks and destroys insulin-producing cells in the pancreas, called beta cells, diabetes occurs. Thousands of people worldwide are diagnosed with type 1 diabetes each year. Millions have the more common form of the disease, known as type 2, which is linked to obesity and advanced age and does not involve destruction of beta cells. Ludvigsson and colleagues invited all families in southeast Sweden with babies born between October 1997 and September 1999 to complete questionnaires distributed during routine physicals and by mail. The researchers found that a serious traumatic event during the first 14 years of life increased the risk of type 1 diabetes, even after taking into account the family history for any form of di Continue reading >>
Childhood Trauma Could Lead To Type 1 Diabetes
Childhood Trauma Could Lead to Type 1 Diabetes Childhood Trauma Could Lead to Type 1 Diabetes Every year, more than 15,000 children in the U.S. are diagnosed with type 1 diabetes (T1D), but health professionals and scientists don't have many answers about the causes and prevention methods for this autoimmune disease. Experts do believe that genetics and environmental triggers are factors in the development of type 1 diabetes , and that diet and exercise are not. A recent study suggests that experiencing traumatic life events during childhood can increase the risk of developing type 1 diabetes later in life. Researchers in Sweden examined more than 10,000 children between the ages of 2 and 14 who had not been diagnosed with T1D. Parents filled out questionnaires that measured their assessment of serious life events (death or illness in the family, conflicts, and divorce), parenting stress, parental worries, and parental social support. Results indicated that kids who had experienced a serious life event during their first 14 years of life were nearly three times more likely to develop T1D than those who had not. The authors of the study concluded that a possible link between stress and diabetes is an imbalance in the immune system. This imbalance could cause an autoimmune reaction against beta cells that produce the insulin necessary to regulate blood sugar. Other possible links between serious life experiences and the development of T1D do exist, and more research is needed to pinpoint when this type of psychological stress alters the autoimmune system. "As experience of stressful life events cannot be avoided, children and their parents should get adequate support to cope with these events to avoid their consequences, which could include medical issues," recommended t Continue reading >>
Traumatic Life Events During Childhood Affect Diabetes Risk | Time
Type 2 diabetes tends to get more attention than type 1, mainly because the risk factors for type 2obesity, for instanceare thought to be more in our control. Type 1 is believed to be primarily a genetic disease, triggered by an unfortunate DNA configuration that signals the bodys immune system to destroy insulin-producing beta cells. Now, in a report published in the journal Diabetologia, Dr. Johnny Ludvigsson, a pediatrician from Linkoping University in Sweden, and his colleagues say that life events, including traumatic experiences such as the death of a family member or a serious accident, can triple the risk that young children have of developing the disease. The researchers studied 10,495 families with children born between 1997 and 1999 and asked them to participate in at least one of four follow-up sessions when the children were between two and 14 years old. The parents filled out questionnaires about whether the children had experienced anything that might be considered a serious life event, including things like the death of a family member, a new sibling, divorce or a move. Parents were also asked about their own stress and whether they felt they had social support. Once the scientists adjusted for factors that also contribute to type 1 diabetes, such as BMI, mothers age and a history of diabetes in the family, children who experienced deaths and accidents in their early years showed a three-fold higher risk of developing diabetes than those who didnt live through these events. People may be worried and have feelings of guilt that not only did their child get diabetes, but that in a way they contribute to it, says Ludvigsson of the results. But parents should take some solace in the fact that after he adjusted for other factors that can contribute to type 1 Continue reading >>
- Debbie Wilson: The Journey Back from Traumatic Brain Injury and Dementia, with a Side of Disappearing Diabetes
- Maternal obesity as a risk factor for early childhood type 1 diabetes: a nationwide, prospective, population-based case–control study
- Risk of diabetes type 1 'can be tripled by childhood stress'
Trauma May Be An Important Cause Of Type 1 Diabetes: Dan’s Story & Symptoms
Have you ever wondered whether trauma is a cause of type 1 diabetes? Or a cause of your chronic illness, whatever it may be? Or why you can be your harshest critic and blame yourself for your chronic disease or symptom flares even though it’s not your fault for getting sick? Writer Dan Fleshler has been asking himself these questions for decades, as I learned in his Huffington Post article, “Did Trauma Cause My Diabetes?” Like so many of us, Dan experienced a stressful event before the onset of his chronic illness and he’s found very little support for his belief that trauma is a cause of type 1 diabetes. Trauma is often mistakenly dismissed as a risk factor for type 1 diabetes (T1D) and the links aren’t readily available or easy to find. The research, however, is beginning to provide more in-depth explanations. Studies show an increased risk for type 1 diabetes (T1D) from serious life events and adverse childhood experiences as well following stressful events in pregnancy, birth and infancy. I tell you about Dan’s onset story in this post and introduce research showing that serious life events such as the one that triggered the onset of his type 1 diabetes are three times more common in those who develop T1D. I’ll then describe how his symptoms support his insight that this seemingly ordinary, everyday event was truly traumatic. You can read my review of 25 years of trauma research in diabetes or download the pdf along with a list of serious life events that increase risk for type 1 diabetes (and other chronic illnesses) with your email (I don’t share your email with anyone). Dan talks about his experiences on his blog The Insulin Chronicles and in the New York Times. Relevance to ME/CFS and Other Chronic Illnesses Many of the characteristics of Dan’s Continue reading >>
The Link Between Mental Trauma And Diabetes
TIME Health For more, visit TIME Health. Women with symptoms of post-traumatic stress disorder (PTSD) have a two-fold increased risk for type 2 diabetes, according to a new study. “When we are under stress we are more likely to get sick, but women with PTSD are in this extreme stress response a lot of the time,” says study author Karestan Koenen, an epidemiology professor at Columbia University’s Mailman School of Public Health. The new study, published in the journal JAMA Psychiatry, looked at 49,739 women participating in the Nurses’ Health Study II to assess the link between PTSD symptoms and type 2 diabetes over 22 years. They found that women with the most symptoms had double the risk of developing type 2 diabetes, and that the association increased based on the number of symptoms women experienced. “It’s so important that people understand PTSD isn’t just in veterans. Most PTSD is just in regular people in the community,” says Koenen. One of the most surprising findings in the study was that using antidepressants and having a higher body mass index (BMI) accounted for about half of the increased risk for type 2 diabetes in women with PTSD. Past research has linked PTSD to having a higher BMI, with some research suggesting that elevated stress response could result in cravings for highly caloric food and lead to weight gain. The antidepressant link is the most unexpected. An obvious explanation for the link is that some antidepressants cause weight gain, but the researchers argue weight gain isn’t caused by all antidepressants and therefore cannot account for all of the effect. “It’s probably one of the most interesting findings and I don’t have a good explanation for it,” says Koenen. The researchers say it’s possible that extreme stres Continue reading >>
Symptoms & Causes Of Diabetes
What are the symptoms of diabetes? Symptoms of diabetes include increased thirst and urination increased hunger fatigue blurred vision numbness or tingling in the feet or hands sores that do not heal unexplained weight loss Symptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble. What causes type 1 diabetes? Type 1 diabetes occurs when your immune system, the body’s system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease. What causes type 2 diabetes? Type 2 diabetes—the most common form of diabetes—is caused by several factors, including lifestyle factors and genes. Overweight, obesity, and physical inactivity You are more likely to develop type 2 diabetes if you are not physically active and are overweight or obese. Extra weight sometimes causes insulin resistance and is common in people with type 2 diabetes. The location of body fat also makes a difference. Extra belly fat is linked to insulin resistance, type 2 diabetes, and heart and blood vessel disease. To see if your weight puts you at risk for type 2 diabetes, check out these Body Mass Index (BMI) charts. Insulin resistance Type 2 diabetes usually begins with insulin resista Continue reading >>
Risk Of Diabetes Type 1 'can Be Tripled By Childhood Stress'
Stressful life events in childhood such as family break-up, death or illness, can triple the risk of developing type 1 diabetes, research suggests. In a study, researchers found that children who experienced an event associated with “major stress” were almost three times more likely to develop the condition than those who had not. The Swedish study analysed more than 10,000 families with children aged between two and 14, who did not already have the condition. The aim was to pinpoint any family conflicts, unemployment problems, alteration of family structure, or intervention from social services. Subsequently, 58 children were diagnosed with type 1 diabetes. The causes of type 1 diabetes are unknown but it is usually preceded by the immune system attacking and killing beta cells in the pancreas, which produce insulin. Based on the results, the researchers, from Linkoping University, said they thought the stressful events could contribute to beta cell stress due to increased insulin resistance as well as increased insulin demand due to the physiological stress response, such as elevated levels of the stress hormone cortisol. In the paper, published on Thursday in Diabetologia (the journal of the European Association for the Study of Diabetes), the authors write: “Consistent with several previous retrospective studies, this first prospective study concludes that the experience of a serious life event (reasonably indicating psychological stress) during the first 14 years of life may be a risk factor for developing type 1 diabetes. “The current study examined serious life events experienced at any time before diagnosis; further studies are thus needed to determine when in the autoimmune process psychological stress may contribute, and in association with which other Continue reading >>
Psychological Stress May Induce Diabetes-related Autoimmunity In Infancy
OBJECTIVE— In retrospective studies, a number of disparate environmental factors (including experiences of serious life events) have been proposed as trigger mechanisms for type 1 diabetes or the autoimmune process behind the disease. Psychosocial stress in families may affect children negatively due to a link to hormonal levels and nervous signals that in turn influence both insulin sensitivity/insulin need and the immune system. Our aim was to investigate whether psychological stress, measured as psychosocial strain in families, is associated with diabetes-related autoimmunity during infancy. RESEARCH DESIGN AND METHODS— The first 4,400 consecutive 1-year-old children from a large prospective population-based project participated in the study. Parents completed questionnaires at birth and at 1 year, including various measures of psychosocial stress (e.g., parenting stress) and sociodemographic background. Blood samples drawn from the children at 1 year were analyzed for type 1 diabetes–associated autoantibodies toward tyrosine phosphatase and GAD. Antibodies toward tetanus toxoid were used as non–diabetes-related control antibodies. RESULTS— Psychosocial factors, i.e., high parenting stress (odds ratio 1.8 [95% CI 1.2–2.9], P < 0.01), experiences of a serious life event (2.3 [1.3–4.0], P < 0.01), foreign origin of the mother (2.1 [1.3–3.3], P < 0.001), and low paternal education (1.6 [1.1–2.3], P < 0.01) were associated with diabetes-related autoimmunity in the child, independent of family history of diabetes. CONCLUSIONS— Psychological stress, measured as psychosocial strain in the family, seems to be involved in the induction, or progression, of diabetes-related autoimmunity in the child during the 1st year of life. Type 1 diabetes is a multifact Continue reading >>
#5 Stress, Trauma And Type 1 Diabetes: Top 7 Reasons We (mistakenly) Dismiss Links
Can stress or trauma cause type 1 diabetes? Or trigger onset? Answers are rarely found despite observed links between stress, trauma and type 1 diabetes (T1D) for over 2000 years. I received an email from Teri in Illinois with this very question while writing this post, I just read your post [about how trauma is making sense of your chronic illness]. I do not know how I found you, but am so grateful. My Son was diagnosed with Type 1 Diabetes in 2011 at 13 years old. Previous to his diagnosis he had a few situations which made me question over the years, what in the world was going on with him. He also was diagnosed with anxiety at age 4 and I was given information on ADHD/ADD and needed to bring him for testing at that time for an early intervention program, which he did not test “low” enough for. At the time he was diagnosed, I looked directly at the endocrinologist and asked if this diagnosis could have had anything to do with stress. She said no. Every endo since this time has said no, even though we know full well cortisol levels and stress have affected his blood sugar levels all along and certainly do to this day. Thank you for confirming there are studies out there for one. But even more so, thank you for sharing your story and putting it in black and white for us. We have known this for years, but it is hard to feel as if you are the only ones who do. Research in T1D and disciplines as diverse as neurophysiology, nervous system development, brain plasticity, epigenetics, child development, attachment, and traumatic stress suggest the answers to Teri’s second question is Yes, trauma can trigger onset of T1D and Yes, trauma contributes to the cause and development of T1D. This article is part of my discovery series presenting research I never knew as an MD. Continue reading >>
Ask Joslin: Could Trauma Have Caused My Diabetes?
Can a traumatic experience or a hospital stay be the cause of my diabetes? The possibility of trauma inducing diabetes has been a topic of interest since Dr. Joslin was practicing medicine in the 1940s. To quote Dr. Joslin from his paper, “The Relation of Trauma to Diabetes,” published in the Annals of Surgery in 1943, “The thesis that trauma de novo can cause diabetes has steadily lost support.” The accumulation of knowledge about diabetes and its origins since that time has only substantiated the fact that, barring a direct substantial insult to the pancreas, diabetes does not arise spontaneously as a result of a traumatic injury. Many people are diagnosed with diabetes after a hospital stay for either a traumatic injury or a heart attack (which in itself is a type of trauma to the body). This can make it appear that there is a causal relationship between the traumatic event and the development of diabetes. However, as they say, correlation is not necessarily causation. The experience simply unmasked a condition that was already present. In reality, people who present with persistent hyperglycemia after a traumatic injury have an underlying defect in glucose metabolism that is laid bare by the metabolic demands of the body’s response to injury. In the case of trauma, the body produces a cascade of hormones that flood the blood stream. Many of these hormones cause the liver to release glucose to provide energy as the body tries to heal itself. Even people who don’t have diabetes may experience a rise in blood glucose above the usual limits that the body tries to preserve. However, their pancreases will quickly take over to produce enough insulin to restore euglycemia. This isn’t the case in people who already barely meet normal metabolic demands. So while Continue reading >>
Did Trauma Cause My Diabetes?
What caused killer t-cells to attack the beta cells in my pancreas, preventing them from producing insulin, making my blood sugar skyrocket and triggering my Type 1 diabetes? That was in 1962. No one has come up with a convincing explanation yet. Scientists aren’t even close to figuring out the interactions between the environment, genes, the immune system and who-knows-what-else that result in Type 1 (T1) or Type 2 (T2) diabetes. If you travel around the Internet, it appears that the entire world is one big “risk factor” for these conditions. Suspects identified by researchers that might play a role in T1D include the smoked mutton consumed by Icelanders between Christmas and New Year’s, various viruses, respiratory infections in early childhood, early exposure to cow’s milk, psoriasis, the timing of infants’ first solid foods, low levels of Vitamin D, and many more. Risk factors for T2D, besides the well-known ones like obesity, could include not enough sleep and phthalates in soaps, lotions, plastics and toys. But the culprit that interests me the most doesn’t get much attention in the research labs: trauma and major stress. When I was a kid, the conventional wisdom was that traumatic events — loss of a loved one, accidents — played an important role in diabetes onset. This appeared to be substantiated by a number of population studies in the ensuing decades, but the evidence hasn’t impressed major players in diabetes research. In a long summary of biochemical and environmental risk factors for T1D, the NIH barely touches upon the matter, gives it a few throwaway lines: Although investigations of stress and IDDM [insulin dependent diabetes] have, in general, reported positive associations, most studies have been retrospective and suffered from met Continue reading >>
Stress
The first longitudinal (long-term) study of stress and type 1 diabetes found that experiencing a stressful event during childhood was associated with an increased risk of developing type 1 diabetes later in life (Nygren et al. 2015). A large study from Denmark found that if a child experienced the death of an immediate family member after age 11, they were more likely to develop type 1 diabetes (Virk et al. 2015). Sepa and Ludvigsson (2006) reviewed earlier studies concerning psychological stress and type 1 diabetes. They found that 9 of 10 studies found associations between stress and type 1 diabetes. Additionally, one large study found an association between stress and type 1-related autoimmunity at early ages in life in the general population. They conclude that psychological stress can accelerate the appearance of type 1 diabetes, and may also contribute to the induction or progression of type 1 diabetes-associated autoimmunity, but more research is needed. The mechanisms for these effects are not known, but may involve stressing the insulin-producing beta cells, or direct influence on the immune system; psychological stress can also increase insulin resistance. Psychological stress in children is linked to changes in the immune system, as well as effects on beta cells (Carlsson et al. 2014). Major life events have also been associated with the onset of type 1 diabetes, possibly due to increased levels of stress hormones, which are also increased in conditions involving inflammation (such as type 1 diabetes) (Dahlquist 2006). A study from Israel found that that trauma of war was associated with an increased risk of type 1 diabetes. Children living in regions that were attacked during the Second Lebanon War had a higher risk of type 1 in the four years after the war, Continue reading >>
