ESPE Abstracts (2018) 89 P-P3-074

Association between Prior Toxic Stressors and Development of T2DM in Adolescents

Adam Adamidisa, Alexander Kneeb, Victoria Cobbc & Rushika Conroya


aUniversity of Massachusetts Medical School-Baystate Children’s Hospital, Division of Pediatric Endocrinology, Springfield, USA; bUniversity of Massachusetts Medical School-Baystate Medical Center, Office of Research, Springfield, USA; cBaystate Children’s Specialty Center, Division of Pediatric Endocrinology, Springfield, USA


Background: Low stress resilience in late adolescence and psychosocial traumatic events in adulthood have been linked to a higher risk of developing type 2 diabetes (T2DM) later on in life. However, limited data is available regarding whether prior stressors are related to the risk of developing T2DM in adolescence.

Objective: We sought to determine the potential association between prior toxic stressors and T2DM in adolescence.

Design/Methods: We conducted a prospective case-control study using a validated 10-question questionnaire (ACE-Q) to evaluate prior exposure to stress events in adolescents. Ten types of adverse childhood experiences were studied falling under 3 categories; household dysfunction, abuse and neglect. A score from 0 to 10 was used to quantify prior exposure to the 10 types of stressors. Eligible participants were males and females aged 15 to 21 years. Cases were diagnosed with T2DM using the ADA criteria no later than 6 months prior to their enrollment and controls did not have T2DM, but presented to our weight management clinic with a BMI z-score ≥1.5, no later than 6 months prior to their enrollment. Our goal was to enroll 30 cases and 60 controls. Enrollment started in November 2016. Data on demographics (age, gender, race, socio-economic factors) and clinical outcomes (A1c, BMI) were obtained by self-report and chart review.

Results: To date, we have approached 33 cases and 30 controls. A total of 8 (24%) cases were enrolled, 4 M and 4 F, aged 15.2-20.2 years, with a BMI z-score ranging from 1.15–2.69 and an A1c ranging from 6.3%–14.3%. In addition, 6 (20%) controls were enrolled, 2 M and 4 F, aged 15.8-20.5 years with a BMI z-score ranging from 2.08 and 2.81. The majority of cases and controls were primary English speakers (87% and 84% respectively) and had public health insurance (71% and 50%). Fifty percent of participants in both groups were Hispanic. Five cases had an ACE score of 1 and the remaining 3 had a score ranging between 2 and 5. Two controls had an ACE score of 0, three had a score of 1 and one had a score of 3. Parental separation was the most common stressor in cases (62%) and controls (100%).

Conclusion: The poor enrollment rate highlights the challenge to assess stress events in adolescence using a questionnaire. Although we are still recruiting, the small size of our sample prohibits us from drawing conclusions.

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