The connection between childhood, teenage abuse and diabetes in women

A new study of nearly 70,000 women found a clear association between abuse in childhood and adolescence and the risk of type 2 diabetes in adult women.

“Much, although not all, of this association is explained by the greater weight gain of girls with a history of abuse,” said lead study author Janet Rich-Edwards. “The weight gain seems to start in teenage years and continues into adulthood, increasing the risk of diabetes.”

But she added, “Weight gain explained only 60 percent of the association, however, implying that the experience of abuse gets incorporated into the body through other mechanisms, as well.”

Rich-Edwards is director of developmental epidemiology at the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital.

“We need to understand how this happens,” she said. “One theory is that abused women develop disordered eating habits as a compensatory stress behavior, leading to excess weight gain. Another theory suggests that child abuse may increase levels of stress hormones that later cause weight gain and insulin resistance, characteristic of diabetes.”

The study appears online and in the December issue of the American Journal of Preventive Medicine.

Participants included 67,853 registered nurses from the Nurses’ Health Study II. On receiving the questionnaire on violence mailed in 2001, “several said, ‘It’s about time you asked about violence!’” Rich-Edwards said.

A stunning 54 percent of nurses reported physical abuse and 34 percent reported sexual abuse before age 18. Moderate and severe physical and sexual abuse were associated with 26 percent to 69 percent higher risks of diabetes in maturity.

“Child abuse can leave an enduring imprint on health in adulthood,” said Rich-Edwards. “We hope to alert clinicians to the possible role of abuse in the histories of some patients that they see with pre-diabetes and diabetes. We also need to help families prevent child abuse and we need to learn the best ways to reduce the long-term health burden that it imposes.”

Fred Rogosch, Ph.D., director of research at the Mt. Hope Family Center at the University of Rochester, called the study “powerful” and said it provides the most compelling evidence to date of the influence of child physical and sexual abuse on the development of type 2 diabetes in women.

“The deleterious effects of child abuse extend beyond the time period of occurrence, resulting in a chain reaction of long-term consequences that impair both physical and mental health across the life course.” Rogosch said. “Preventing child abuse and ameliorating its effects hold promise for improving public health.”