Psychological Trauma Symptoms and Type 2 Diabetes Prevalence, Glucose Control, and Treatment Modality Among American Indians in the Strong Heart Family Study

J Diabetes Complications. Nov-Dec 2013;27(6):553-7. doi: 10.1016/j.jdiacomp.2013.07.008. Epub 2013 Sep 16.


Aims: The aims of this paper are to examine the relationship between psychological trauma symptoms and Type 2 diabetes prevalence, glucose control, and treatment modality among 3776 American Indians in Phase V of the Strong Heart Family Study.

Methods: This cross-sectional analysis measured psychological trauma symptoms using the National Anxiety Disorder Screening Day instrument, diabetes by American Diabetes Association criteria, and treatment modality by four categories: no medication, oral medication only, insulin only, or both oral medication and insulin. We used binary logistic regression to evaluate the association between psychological trauma symptoms and diabetes prevalence. We used ordinary least squares regression to evaluate the association between psychological trauma symptoms and glucose control. We used binary logistic regression to model the association of psychological trauma symptoms with treatment modality.

Results: Neither diabetes prevalence (22%-31%; p=0.19) nor control (8.0-8.6; p=0.25) varied significantly by psychological trauma symptoms categories. However, diabetes treatment modality was associated with psychological trauma symptoms categories, as people with greater burden used either no medication, or both oral and insulin medications (odds ratio=3.1, p<0.001).

Conclusions: The positive relationship between treatment modality and psychological trauma symptoms suggests future research investigate patient and provider treatment decision making.

Keywords: American Indians; Diabetes treatment modality; Psychological trauma symptoms.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Anxiety Disorders / blood
  • Anxiety Disorders / complications
  • Anxiety Disorders / epidemiology*
  • Blood Glucose / metabolism
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / psychology
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Humans
  • Indians, North American
  • Life Change Events
  • Male
  • Middle Aged
  • Prevalence
  • Stress, Psychological / blood
  • Stress, Psychological / complications
  • Stress, Psychological / epidemiology*


  • Blood Glucose