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Nearly one in four U.S. adults over the age of 65 have diabetes. Older veterans are highly impacted by this disease, due in part to risk factors incurred during their military service, such as exposure to Agent Orange and posttraumatic stress disorder (PTSD). Diabetes requires active and ongoing daily self-management and increases the risk of developing other chronic health conditions, which negatively impact functioning and disability.

In a new study published in Health Psychology, researchers have found that veteran men and women with both PTSD and diabetes were at heightened risk of disability and poor physical health functioning compared with veterans with neither condition or PTSD and diabetes only. This is one of the first large-scale studies to investigate the impact of co-occurring PTSD and diabetes on functioning and disability outcomes.

"Veterans with both PTSD and diabetes are at heightened risk for poor functioning and greater disability, which has consequences for their long-term health, " explains lead and corresponding author Kelsey N. Serier, Ph.D., a clinical research psychologist in the VA's National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System and assistant professor of psychiatry at Boston University Chobanian & Avedisian School of Medicine. "Our findings highlight the importance of screening for PTSD in care settings where diabetes is likely to be diagnosed and managed."

The study used data collected from two large-scale epidemiologic cohorts of Vietnam War-era veterans, both men and women. Men were recruited from the Vietnam Era Twin Registry and women from an existing roster of all women Veterans who served during that era were identified for the Health of Vietnam Era Women's Study. Participants in both cohorts completed a survey and separate telephone interviews about their health and experiences in the several decades following their military service.

According to the researchers, this study draws attention to the unique challenges faced by veterans who are managing both PTSD and diabetes and highlights the need for treatment strategies to mitigate the effects of both conditions on long-term functioning.

"More broadly, these findings underscore the need for our research and models of care to attend to the relationship between mental and physical health as traumatic stress exposure, including PTSD, has long-term effects and can further complicate the functioning and well-being of veterans managing chronic health conditions, such as diabetes, " says senior author Brian N. Smith, Ph.D., Deputy Director and research health scientist, National Center for PTSD Women's Health Sciences Division and associate professor of psychiatry at BU.

More information: Kelsey N. Serier et al, Functioning and disability consequences of comorbid posttraumatic stress disorder and diabetes in Vietnam era men and women veterans, Health Psychology (2025). DOI: 10.1037/hea0001516  Journal information: Health Psychology