Post-traumatic stress disorder (PTSD) is widely recognized for its psychological effects, but research increasingly shows it also impacts physical health, particularly metabolic health.

Survey data collected from World Trade Center workers with PTSD found they had a 3x greater risk of developing cardiovascular disease as compared to those without injuries or PTSD. The study, led by Robert M. Brackbill, found that PTSD was significantly associated with having any chronic conditions diagnosed in 2002–2007.

For veterans, the invisible wounds of trauma can manifest in severe chronic conditions like insulin resistance and type 2 diabetes. This connection underscores why regular A1C testing is so critical—and how Veterans Affairs (VA) resources can help.

How PTSD Affects the Body Beyond the Mind

PTSD triggers a cascade of biological changes that don’t just stay confined to mental health. Chronic stress activates the body’s “fight or flight” response, leading to prolonged periods of high cortisol and adrenaline levels. While useful during actual danger, these hormones, when elevated over time, can wreak havoc on the body’s metabolism.

Studies have linked PTSD to potential insulin resistance, a condition where the body’s cells stop responding properly to insulin. A study led by Madhu Rao found that participants with PTSD had a hyperinsulinemic response to oral glucose challenge compared to controls, suggestive of insulin resistance.

Insulin resistance is a major risk factor for type 2 diabetes, which, if unmanaged, can lead to serious complications like heart disease, kidney failure, nerve damage, and vision loss. Veterans living with PTSD are at an increased risk of developing diabetes because of these chronic stress-related metabolic changes. Untreated PTSD doesn’t just affect mental health—it can also significantly raise the risk of metabolic diseases.

The Importance of A1C Testing for Veterans

Because PTSD can quietly drive metabolic changes for years, routine A1C testing becomes an essential tool for early detection and management of diabetes.

The A1C test measures the percentage of hemoglobin in the blood that has glucose attached to it, providing a picture of a person’s average blood sugar levels over the past 2-3 months. According to the Veterans Health Library, A1C testing is one of the best ways to monitor diabetes risk because it captures long-term patterns rather than just daily fluctuations.

The American Diabetes Association states that normal A1C is typically below 5.7%. An A1C between 5.7% and 6.4% indicates prediabetes, a warning sign that action is needed to prevent the development of Type 2 diabetes. An A1C of 6.5% or higher on two separate tests confirms a diagnosis of Type 2 diabetes.

Given the link between PTSD and insulin resistance, veterans, especially those with a PTSD diagnosis, should work closely with their healthcare providers to regularly check their A1C levels, even if they aren’t experiencing obvious symptoms.

VA Support for Veterans at Risk of Diabetes

Fortunately, the VA offers extensive support for veterans concerned about diabetes or metabolic health. Through VA programs, veterans can access screening, education, treatment, and ongoing management for diabetes.

Per the Veterans Health Library, VA services for diabetes include:

  • Regular A1C testing
  • Nutrition counseling
  • Weight management programs
  • Blood sugar monitoring tools
  • Education about exercise, healthy eating, and medication management
  • Access to medications like insulin when needed

The VA emphasizes early detection and lifestyle changes as a critical part of diabetes prevention. Veterans enrolled in VA healthcare are encouraged to schedule annual checkups that include A1C testing, blood pressure monitoring, and cholesterol screening. 

For veterans already diagnosed with diabetes, the VA provides coordinated care teams, including doctors, nurses, dietitians, and diabetes educators, who help manage the condition effectively and prevent complications

Proactive Health Monitoring: Taking Control of Metabolic Health

Because diabetes can develop silently, proactive health monitoring is essential. Veterans living with PTSD may not realize that physical changes are happening inside their bodies until symptoms become serious. High blood sugar often causes no symptoms in its early stages, making regular A1C testing critical. 

Simple lifestyle changes can make a profound difference. According to the VA health experts, managing stress through therapy, regular physical activity, healthy eating, and medication when needed can help regular blood sugar levels and improve overall health. Importantly, addressing PTSD itself through counseling, peer support, or VA mental health services may also help mitigate some of the biological pathways that lead to insulin resistance.

Protecting the Health of Those Who Served

PTSD is more than a psychological battle—it’s a physical one too. For veterans, understanding the link between trauma, metabolic health, and diabetes is vital. Routine A1C testing provides a simple, powerful tool to catch potential problems early and manage them effectively. 

The VA’s robust healthcare programs are available to help veterans navigate these challenges, offering tools, resources, and support every step of the way. Veterans are encouraged to talk to their healthcare teams about getting regular A1C tests and exploring personalized plans for maintaining metabolic health. 

For more information, visit the VA’s resources on A1C testing and managing diabetes.

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