Early-Life Stress as a Determinant of Type 2 Diabetes Risk: A Narrative Review

Type 2 diabetes mellitus (T2DM) remains a major public health concern in the United States, with rising prevalence and a large population at risk for disease progression. Although T2DM is traditionally associated with adult lifestyle factors such as obesity, diet, and physical inactivity, growing evidence suggests that susceptibility to metabolic dysfunction may also be shaped by early-life experiences. Adverse childhood experiences (ACEs), including abuse, neglect, and household dysfunction, have been consistently associated with increased diabetes risk, earlier disease onset, and poorer glycemic control in adulthood. This narrative review synthesizes epidemiologic, behavioral, and biological evidence, linking ACE exposure to T2DM risk across the life course and highlights mechanistic pathways that may contribute to metabolic dysregulation.