A fascinating thing about medicine is that researchers sometimes discover connections between two health concerns that would appear to be unrelated. That’s the case with a new report from Israel, published in the Journal of Clinical Endocrinology and Metabolism, that suggests young men who stutter might have an increased risk of developing early-onset type 2 diabetes.
The researchers based their findings on an analysis of data from young people (ages 16 to 20) in Israel who were evaluated for military service between 1980 and 2013. The subjects numbered about 1.25 million men and nearly 900,000 women. From this population the researchers identified approximately 4,400 men and 500 women who stuttered (researchers aren’t sure why, but stuttering affects four times as many men as women).
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Data analysis showed that type 2 diabetes developed in 3.6% of the men who stuttered but only in 2.1% of the men who didn’t. The researchers then adjusted for a batch of other factors, such as age, body-mass index (BMI, a measure of weight relative to height), country of birth, education, socioeconomic status and whether the subjects had other illnesses or psychiatric issues, and they still found an association between stuttering and type 2 diabetes. The researchers were also able to identify nonstuttering brothers of male stutterers and reported that the stuttering brothers were more likely to develop diabetes. Interestingly, the researchers determined that the stutters who were born more recently (1980 or after) showed a higher risk of diabetes than the others, although stutterers in both age groups were at higher risk. The analysis of the women reported that 1.4% of the stutterers developed type 2 diabetes while 1.1% of the non-stutterers did, a difference that was not considered significant.
What could possibly be the link between stuttering and diabetes? The researchers suggested several. First, they speculated that social anxiety might play a role — that is, social anxiety leads to high levels of cortisol, a major stress hormone that is known to raise blood sugar levels. As they explained it, “Chronic stress and increased secretion of cortisol could increase the risk for type 2 diabetes independently from obesity.” Another possibility is an impairment in the regulation of brain dopamine metabolism, which has been connected to both stuttering and type 2 diabetes. Changes in blood flow might lead to the impairment of glucose-sensing neuronal networks in the hypothalamus, a part of the brain that controls many body functions. Finally, the cause might have to do with structural abnormalities in the brain that affect both stuttering and type 2 diabetes.
Senior author Gilad Twig, MD, in an interview with the website Medscape Medical News, said, “Our results highlight the importance of reduction of other modifiable risk factors for diabetes, especially obesity, and the importance to adopt a healthy lifestyle. We also think that people with stuttering may deserve a tighter follow-up, but additional studies are needed to confirm this… For early onset type 2 diabetes, we have several ongoing studies that opt to characterize other risks for incident diabetes.” For now, he pointed out, “The main clinical takeaway is that stuttering is a medical condition that requires careful risk stratification and mitigation of concomitant diabetes risk factors. This is of special importance since people with stuttering tend to avoid medical encounters.”
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