Health outcomes associated with posttraumatic stress disorder and depressive symptoms among Indigenous adults with type 2 diabetes

Benjamin D. Aronson, Ohio Northern University
Laura C. Palombi, University of Minnesota - Duluth
Melissa L. Walls, University of Minnesota - Duluth


Indigenous communities are differentially impacted by diabetes, trauma, and posttraumatic stress disorder (PTSD) compared to the general population. Prior literature has demonstrated worse diabetes outcomes for those with mental health conditions, but there is a paucity surrounding the impact of PTSD for Indigenous individuals. We examine the prevalence, associated trauma, and health outcomes correlated with PTSD and depressive symptoms among Indigenous adults with diabetes.

Data is from the Mino Giizhigad (A Good Day) study, a community based participatory research collaboration between two tribal communities and a university research team. Indigenous adults with type 2 diabetes (n=218) were randomly sampled from clinic records. Participants completed interviewer-administered surveys assessing PTSD (Primary Care PTSD), depressive symptoms (PHQ-9), high blood sugar, hospitalization, and self-rated health status. Descriptive statistics, chi-square difference tests, and multivariate logistic regression models were used to analyze the data.

Using a cutoff of three or higher on the PC-PTSD 21.8% of participants screened positive for PTSD. Loss of loved ones and abuse (physical/sexual) were the most commonly reported trauma sources. After controlling for other factors, those with both PTSD and depressive symptoms were more likely to have hospitalization (Odds Ratio 6.33; p = 0.001) and low self-rated health status (Odds Ratio 5.33; p = 0.004) compared to those with neither.

This study found relatively high rates of PTSD among a sample of Indigenous adults with diabetes. It also demonstrated separate and potentially cumulative negative health outcomes associated with PTSD and depressive symptoms.