As a child, LR lived with neglect and mistreatment by their parents. Escaping home as a teenager, LR couch surfed at friends but finally ending up living in their car. At the age of 23, LR showed up at our local community clinic with dysregulation, depression, and anxiety coupled with a new diagnosis of type 2 diabetes and elevated triglycerides. LR had limited access to healthy food and carried a BMI of over 35.
After a few months of getting comfortable with the clinic staff, our counselor asked LR to complete the Adverse Childhood Experiences (ACE) screening assessment. After LR finished checking off their adverse childhood experiences, they looked up with tears and said, “I scored a 9 out of 10”.
Adverse Childhood Experiences (ACEs) are common. At least two-thirds of people living in the U.S. have experienced one ACE and over 15% have experienced 4 or more.
Furthermore, a dose-response relationship exists: as the number of adverse experiences increases so does the risk of problems from childhood through adulthood.
These childhood traumas can lead to toxic stress which, over time, can change the biology of our bodiy.
People with elevated ACE scores are more likely to experience a variety of mental health issues, which is not surprising given their painful, confusing, and unsafe childhoods. Based on sound research by the CDC and Kaiser, they are also more likely to suffer from physical diseases, like heart attack and stroke, diabetes, and cancer. They are more likely to break bones and experience unintended pregnancies.
Join Coach Beverly at an Upcoming Webinar
The Impact of Adverse Childhood Experiences on Health: A Personal Story of Resilience and Hope with Coach Beverly
ADCES National Virtual Meeting – Ready for Viewing
California Coordinating ADCES Chapter – September 30, 2021 at 4:45pm PST
Diabetes Ed Services Webinars – airs October 27th at 11:30 am PST
Toxic Stress Affects us at the Cellular Level
Research shows that ACEs can lead to a cycle of toxic stress and cellular inflammation. This heightened adrenal-mediated “flight or fight” response over time, can lead to neuroendocrine dysregulation, altered immune response, affect DNA packaging and activate epigenetic tags that can alter genetic makeup.
The CDC Morbidity and Mortality Weekly 2019 report tell us that preventing ACEs could reduce:
- 21 million cases of depression
- 1.9 million cases of heart disease
- 2.5 million cases of excess weight
The first Surgeon General of California, Nadine Burke Harris, MD, MPH, has made it her mission to increase awareness, identify and address ACEs with parents, children, and adults so that we can break the cycle.
Health care professionals at risk for ACEs
People who enter healing professions may be experiencing toxic stress from childhood or current trauma. They may be dealing with burnout, fear, or feelings of deep pain with their past coupled with all the intensity of providing care during the COVID pandemic. This chronic and toxic stress can lead to dysregulation while impairing our ability to cope and care for others. You are not alone.
My own personal journey of experiencing childhood trauma and holding myself together until I ended up in the hospital, has compelled me to share my story with you. And offer a message of hope.
Coach Beverly
As I work on healing and integrating the different aspects of myself, I now feel more attuned to others who have weathered and survived childhood trauma. This awareness has significantly changed the way I hear what people with diabetes are saying and interpret what they are doing. For example, knowing that LR had a very high ACE score, I was able to adjust my expectations and focus on behavior changes that support self-care and self-regulation. When LR doesn’t take their diabetes medications for a few weeks, I provide gentle strength-based coaching to help LR get back on track. I make sure LR knows that they are safe sharing the truth of their story, no matter what.
In your hospital setting, do you have a person who keeps getting readmitted to the hospital in a diabetes crisis? In your outpatient setting, do you experience frequent no-shows or situations where people aren’t able to make changes in self-care? Maybe, they are struggling with the emotional impact of toxic stress.
Adults who have experienced trauma as children may exhibit the following behaviors:
- Missing appointments
- Not taking meds as prescribed
- Not adopting new lifestyle changes
As Diabetes Care and Education Specialists, if we recognize these behaviors as a response to dysregulation due to toxic stress, we can provide a therapeutic response to start the healing process.
Helpful provider responses when you suspect that participants are not engaging in care due to childhood trauma and toxic stress:
- Refrain from harsh language or judgement
- Be curious, ask open ended questions
- Provide the ACE screening tool to start the conversation
- Encourage collaboration using a person centered approach
- Identify mental health resources in you community
Diabetes Care and Education Specialists recognize that the mind and body are a deeply connected, dynamic, and powerful force when they are working together in harmony. When trauma and toxic stress are not recognized or treated, there can be devastating health consequences. We can make a difference in preventing, recognizing, and helping people heal from adverse childhood experiences.
Want to learn more about the ACEs and Healing?
Join Coach Beverly at an Upcoming Webinar
The Impact of Adverse Childhood Experiences on Health:
A Personal Story of Resilience and Hope with Coach Beverly
ADCES National Virtual Meeting – Ready for Viewing
California Coordinating ADCES Chapter – September 30, 2021 at 4:45pm PST
Diabetes Ed Services Webinars – airs October 27th at 11:30 am PST
Resources
ACE Screening Tool and Resilience Inventory
Becoming ACE-Aware Training Program
Nadine Burke Harris, MD TED Talk on How Childhood Trauma affects health
NPR Article – Take the ACE Score and Learn what it does and doesn’t mean
Trauma-Informed Care Fact Sheet
Why should I care about my number?
CDC Vital Signs – Impact of ACES
CDC Mortality and Morbidity Weekly Report on ACEs – 2019
What happened to you? Conversations on Trauma, Resilience, and Healing – authors Oprah Winfrey and Bruce D. Perry, M.D., Ph.D.
Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below!
[yikes-mailchimp form=”1″]Accreditation: Diabetes Education Services is an approved provider by the California Board of Registered Nursing, Provider 12640, and Commission on Dietetic Registration (CDR), Provider DI002. Since these programs are approved by the CDR it satisfies the CE requirements for the CDCES regardless of your profession.*
The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
![](/wp-content/uploads/2023/01/insta-png-v5.png")
