Association between Adverse Childhood Experiences (ACE) and Type 2 Diabetes Mellitus (T2DM)

Abstract In Mexico, Type 2 diabetes mellitus (T2DM) affects the population with a high prevalence of approximately 18.3%; adverse childhood experiences (ACEs) are a major public health issue and have been associated with chronic degenerative diseases, such as T2DM. A prospective cross-sectional study was conducted among 216 individuals (66.7% women; median age 52 [40-63]). Participants self-reported T2DM status and completed the Spanish version of the WHO ACE questionnaire. Statistical analysis was performed using the chi-square test, with a 95% confidence interval (95%CI). Of the participants, 52.8% had T2DM. Those with T2DM had significantly higher ACE scores (median 3 [1.5] vs 1 [0-3], p = 0.0001) and a higher prevalence of ACEs (80.7% vs 58.8%, p = 0.0001) compared to individuals without T2DM. Additionally, 46.5% of individuals with T2DM reported four or more ACEs, versus 17.6% of those without T2DM (p = 0.0001). The history of ACEs was associated with increased odds of T2DM (OR 2.9, 95% CI 1.5-5.3, p = 0.0001), and the association was stronger among those with ≥4 ACEs (OR 4, 95%CI 2.1-7.5, p = 0.0001). Significant domain-specific associations with T2DM were found for physical neglect (OR 5.3), emotional neglect (OR 3.9), sexual abuse (OR 2.5), death or abandonment (OR 4.6), caregiver with mental illness (OR 2.1), and caregiver with substance use disorders (OR 2.5) (all p < 0.05). ACEs, particularly in high cumulative numbers, are significantly associated with T2DM in the Mexican population. These findings highlight the importance of early-life interventions to prevent chronic diseases later in life. Key messages • Adverse childhood experiences (ACEs), particularly accumulated, are significantly associated with increased risk of type 2 diabetes mellitus (T2DM) in the Mexican population. • Early identification and intervention for ACEs may serve as a critical public health strategy to reduce the burden of chronic diseases such as T2DM later in life.