• Sara A Miller-Archie, Hannah T Jordan, Ryan R Ruff, Shadi Chamany, James E Cone, Robert M Brackbill, Joanne Kong, Felix Ortega, and Steven D Stellman.
• World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY 11101, USA. Electronic address: smille12@health.nyc.gov.
• Prev Med. 2014 Sep 1; 66: 34-8.

ObjectiveTo explore the temporal relationship between 9/11-related posttraumatic stress disorder (PTSD) and new-onset diabetes in World Trade Center (WTC) survivors up to 11 years after the attack in 2001.MethodsThree waves of surveys (conducted from 2003 to 2012) from the WTC Health Registry cohort collected data on physical and mental health status, sociodemographic characteristics, and 9/11-related exposures. Diabetes was defined as self-reported, physician-diagnosed diabetes reported after enrollment. After excluding prevalent cases, there were 36,899 eligible adult enrollees. Logistic regression and generalized multilevel growth models were used to assess the association between PTSD measured at enrollment and subsequent diabetes.ResultsWe identified 2143 cases of diabetes. After adjustment, we observed a significant association between PTSD and diabetes in the logistic model [adjusted odds ratio (AOR) 1.28, 95% confidence interval (CI) 1.14-1.44]. Results from the growth model were similar (AOR 1.37, 95% CI 1.23-1.52).ConclusionThis exploratory study found that PTSD, a common 9/11-related health outcome, was a risk factor for self-reported diabetes. Clinicians treating survivors of both the WTC attacks and other disasters should be aware that diabetes may be a long-term consequence.Copyright © 2014. Published by Elsevier Inc.

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