A dose-response association was found between physical abuse and risk of diabetes. However, this was somewhat attenuated by adjustment for race, maternal and paternal education, maternal and paternal diabetes, and somatotype at age 5.
Physical and sexual abuse interacted on an additive scale but not on a multiplicative scale, indicating that the absolute risk of diabetes was greater among women who had experienced both forms of abuse than would be expected from the risk of sexual or physical abuse alone, according to Dr. Rich-Edwards and her coauthors.
At age 5 years, little difference was found between the somatotypes of girls who did and did not report later abuse. By the age of 18 years, however, the BMI trajectories of abused girls had begun to diverge.
By ages 25-42 years, a marked trend was found of increasing BMI with more severe abuse history.
Adjustment for adult smoking, alcohol use, and BMI weakened, but did not eliminate, the dose-response associations of child and teen abuse with risk of adult diabetes. The attenuation was attributable almost entirely to adjustment for adult BMI, which accounted for 60% and 64% of the associations of physical and sexual abuse, respectively, with diabetes.
Despite adjustment, moderate physical abuse, severe physical abuse, and repeated forced sex remained independently associated with significantly increased risks of diabetes of 12%, 21%, and 28%, respectively.
Moderate and severe physical abuse were associated with 26%-54% higher risks of diabetes in maturity. Unwanted sexual touching was associated with 16% higher risk of diabetes, and forced sexual activity before adulthood carried a 34% greater risk when it occurred once and a 69% greater risk when it occurred more frequently. Child and teen abuse predicted later diabetes even among women who reported no adult physical or sexual abuse.