The Effects of Posttraumatic Stress Disorder, Major Depressive Disorder, and Emotion Dysregulation Symptom severity on Insulin response in African American Women with Type 2 Diabetes Mellitus Público

Abstract

Background: Type 2 Diabetes Mellitus disproportionately affects African American women, as they are twice as likely to have T2DM compared to Caucasian women. T2DM is highly comorbid with psychiatric disorders like post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and emotion dysregulation (ED). Additionally, urban dwelling women of color experience higher rates of trauma exposure, MDD, and PTSD compared to the general population.

Objective: To determine whether symptoms of PTSD, MDD, and ED are predictive of altered glucose homeostasis and elevated insulin resistance in urban dwelling, African American women with T2DM.

Methods: The present study utilized a cross-sectional design in which participants were recruited from the diabetic clinic Grady Memorial Hospital. Participants came in a fasted state to the laboratory for baseline blood draws, a clinical assessment, and the 2-hour Oral Glucose Tolerance Test (OGTT). PTSD, MDD, and ED symptoms were assessed through the Modified PTSD Symptom Scale (MPSS), Beck Depression Inventory-II (BDI), and Difficulties in Emotion Regulation Scale (DERS) questionnaires, respectively. Area under the curve measures were obtained from the OGTT and used in the assessment of insulin and glucose homeostasis.

Results: More severe symptoms of PTSD, MDD, and ED were all associated with lower insulin sensitivity and higher blood glucose levels. Compared to other symptoms, depressive symptoms were most predictive of dampened insulin sensitivity, while ED symptoms were most predictive of heightened plasma glucose.

Conclusion: Symptoms of PTSD, MDD, and ED were all predictive of reduced insulin sensitivity and increased blood glucose in women with T2DM, which is indicative of heightened insulin resistance. These findings suggest that glucose regulation is highly related to the symptom severity of PTSD, MDD, and ED in women with T2DM and may inform future therapeutic avenues. 

Table of Contents

Introduction.....................................................................................................1

Methods.........................................................................................................5

Results.........................................................................................................10

Discussion.....................................................................................................13

Tables and Figures...........................................................................................20

Table 1: Sample Demographics.........................................................................20

Table 2: Descriptive statistics for metabolic measures involved in altered glucose homeostasis and insulin sensitivity......21

Table 3: Descriptive statistics for each psychopathology measure and accompanying subclusters, and correlation coefficients generated from Pearson’s r correlations.....22

Figure 1: Associations between AUC measures of insulin and glucose with PTSD symptom severity........23

Figure 2: Associations between AUC measures of insulin and glucose with ED symptom severity.........24

Figure 3: Associations between AUC measures of insulin and glucose with MDD symptom severity.......25

References.....................................................................................................26

Appendix.......................................................................................................32 

About this Honors Thesis

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School	Emory College
Department	Neuroscience and Behavioral Biology
Degree	B.S.
Submission	Honors Thesis
Language	English
Research Field	Biology, Endocrinology Biology, Neuroscience Psychology, Clinical
Palabra Clave	Post-traumatic Stress Disorder Type 2 Diabetes Mellitus Major Depressive Disorder Insulin sensitivity Emotion Dysregulation
Committee Chair / Thesis Advisor	Vasiliki Michopoulos, Emory University
Committee Members	Paul Lennard, Emory University Charles Gillespie, Emory University

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