Prediabetes Progression to Diabetes among Veterans with Post Traumatic Stress Disorder

Prevalence of diabetes and prediabetes, post-traumatic stress disorder (PTSD) as well as atherosclerotic cardiovascular disease is very high among veterans. The primary aim of this study is to compare the rate of progression of prediabetes to diabetes among veterans with or without PTSD and associated conditions and or risk factors for that. This retrospective observational database study included all subjects with prediabetes based on HbA1C (5.7 to 6.4), after exclusion criteria between 2008 and 2019 at Veterans Health Administration at Columbia, South Carolina. PTSD codes were used to identify veterans with PTSD. Subjects with prediabetes identified include 72,604 with mean age of 66 and mean HbA1C of 5.9% and 29% of them had PTSD. Follow-up data is available for 62,184 subjects. Among those who had follow-up, 35% progressed to diabetes, while 65% remained as prediabetic. Progression to diabetes negatively is correlated with HbA1C (r = 0.34; p < 0.001). Associated other risks include obesity, hypertension and atherosclerotic cardiovascular disease. The rate of progression was higher among subjects with PTSD though much younger than those without PTSD.