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PACEs in Pediatrics

Exploring the Connection Between Adverse Childhood Experiences and Diabetes

 

Life is hard. None of us makes it through unscathed. Unfortunately, though, some of us have a much tougher journey on this planet than others. Most distressingly of all, children and babies are by no means immune from the wounds that this world all too often inflicts.

Indeed, for many children, trauma is not a future threat but a present reality. And these adverse childhood experiences (ACE) can have a devastating long-term impact across all domains of a child’s life. This includes instigating severe physical and mental illnesses in adulthood.

There is, in fact, mounting evidence of a significant and direct connection between ACE and serious chronic illness, including diabetes.

Understanding ACE

All children experience emotional pain as they grow up. This is a part and parcel of living and being in the world. However, from a psychological standpoint, an adverse childhood experience (ACE) is something profoundly different. An ACE is a trauma that leaves a lasting negative imprint on the child’s mind, spirit, and, often, on their body.

ACE comes in many forms, from parental neglect to physical, sexual, and emotional abuse. However, ACEes do not always involve the infliction of harm on the baby or child. Adverse experiences may also derive from a significant illness in the child, sibling, parent, or other close relative or friend.

It may also relate to stress or conflict in the home, including parental divorce or separation or financial hardship in the household.

The determinative factor is the significant and prolonged stress, fear, and/or physical or emotional pain caused by the adverse event. Without the proper coping skills, children who have experienced one or more traumatic events, whatever the type or cause, may lapse into unhealthy and self-destructive behaviors. And, again, without care, these behaviors can linger well into adulthood, giving rise to a host of illnesses, including diabetes.

ACE and Diabetes Risk

The connection between a history of childhood trauma and risk for mental illness, addiction, and other behavioral disorders has long been understood. However, continuing studies of the long-term impacts of ACE are revealing a profound impact on overall adult health.

Researchers have found that the risk of adult-onset diabetes is substantially higher in persons with ACE than for the general population, but the exact nature of the connection isn’t yet clear. However, it appears that childhood adversity catalyzes an array of physiological, psychological, and behavioral attributes that often set the stage for the development of diabetes.

For example, there is evidence that adversity related to parental separation, death, or divorce, can contribute to the development of depressive disorders and obesity. Children who have experienced adversity, for instance, appear to be more likely to develop sugar addiction and weight gain than children who have not.

Food addictions are often accompanied by the emergence of a sedentary lifestyle, particularly in the presence of depressive disorders, which are characterized by a loss of motivation. The result is a perfect storm in which children develop behavioral patterns that undermine both their physical and their mental well-being.

And this painful cascade, ultimately, is propelled by the child’s dysfunctional attempt to cope with the adversity they have experienced, to self-medicate with unhealthy food.

Teaching Resilience

As described above, the connection between ACE and adult-onset diabetes appears to be informed principally by the emergence of unhealthy lifestyle patterns in response to trauma. For this reason, proactive interventions are urgently needed to help children develop the coping skills they need to be resilient in the aftermath of adversity.

One of the most important things parents and caregivers can do, for example, is provide the child with mental health care when they have experienced an adverse event. Therapists specializing in children and family counseling can help young ones process their emotions and develop healthy, more self-affirming coping skills.

In addition to mental healthcare, children facing adversity must also be provided with resources to protect their physical health, particularly, if a diagnosis of diabetes has already been made. All children need education and support on topics such as proper nutrition and the importance of physical exercise in the aftermath of trauma.

For children who are dealing with a diabetes or prediabetes diagnosis, though, the need for intensive support in health and disease management is especially urgent. This might necessitate the inclusion of a nutritionist, exercise physiologist, and endocrinologist in the child’s healthcare team. When working in conjunction with a mental healthcare provider, the healthcare team can provide the holistic support the child needs to develop resiliency, regardless of the nature of the adversity they may face.

The Takeaway

No one likes to think of childhood as anything other than a time of innocence and joy. For far too many children, however, life begins with adversity. And these adverse childhood experiences (ACE) can leave an indelible mark on the child’s mental, emotional, and physical health. This includes putting the child at significant risk for developing diabetes at some point in their lives. With prompt and proactive intervention from mental, physical, and behavioral health specialists, children can develop the resilience they need to overcome ACE and prevent diabetes.



Image Source: https://pixabay.com/photos/gir...r-child-walk-447701/

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Very good article. Important citation. The connection between childhood trauma and physical disease (as distinguished from psychological turmoil) is often overlooked, especially among medical doctors. If only they would appreciate this situation! See my article "The importance of child abuse and neglect in adult medicine," Jeoffry B. Gordon, Pharmacology, Biochemistry and Behavior 211 (2021) 173268 Available online 7 September 2021.

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