Ask Joslin: Could Trauma Have Caused My Diabetes?

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Can a traumatic experience or a hospital stay be the cause of my diabetes?

The possibility of trauma inducing diabetes has been a topic of interest since Dr. Joslin was practicing medicine in the 1940s.  To quote Dr. Joslin from his paper, “The Relation of Trauma to Diabetes,” published in the Annals of Surgery in 1943, “The thesis that trauma de novo can cause diabetes has steadily lost support.”

The accumulation of knowledge about diabetes and its origins since that time has only substantiated the fact that, barring a direct substantial insult to the pancreas, diabetes does not arise spontaneously as a result of a traumatic injury.

Many people are diagnosed with diabetes after a hospital stay for either a traumatic injury or a heart attack (which in itself is a type of trauma to the body). This can make it appear that there is a causal relationship between the traumatic event and the development of diabetes.  However, as they say, correlation is not necessarily causation. The experience simply unmasked a condition that was already present.

In reality, people who present with persistent hyperglycemia after a traumatic injury have an underlying defect in glucose metabolism that is laid bare by the metabolic demands of the body’s response to injury.   In the case of trauma, the body produces a cascade of hormones that flood the blood stream. Many of these hormones cause the liver to release glucose to provide energy as the body tries to heal itself.

Even people who don’t have diabetes may experience a rise in blood glucose above the usual limits that the body tries to preserve. However, their pancreases will quickly take over to produce enough insulin to restore euglycemia.  This isn’t the case in people who already barely meet normal metabolic demands. So while it may seem that a traumatic experience or hospital stay causes diabetes, it simply brings to the forefront sooner something that was already lurking.

One Response to Ask Joslin: Could Trauma Have Caused My Diabetes?

  1. David Daar says:

    The answer to the question – Does trauma cause diabetes becomes even more complex when viewed from a legal standpoint.
    The inquiry continues — If the “traumatic event” is an external physical event such as that resulting from a sudden blow, impact, collision or other substantial continuing traumatic life experience.
    If such external trauma brings forth a level of diabetes that was already lurking in the individual, then the legal issue arises – has there been an “aggravation of a pre-existing condition”. The law accepts “aggravation” of a medical condition as a legally recognized event. Thus, while medically -scientifically – trauma is not a cause of diabetes, in some circumstances trauma can fall within the legal ambit of “aggravation of pre-existing conditions”. Not necessarily easy of proof – but there in reality.