Purpose: This study aimed to examine the role of personality functioning in the association between various types of child maltreatment (CM) (sexual, physical, and emotional abuse as well as physical and emotional neglect) and diabetes in adulthood.

Methods: Analyses are based on representative data of the German population (N= 5,041) from 2016 to 2019. Self-report questionnaires assessed diagnosis of diabetes, child maltreatment (CTQ), personality
functioning (OPD-SQS), and symptoms of depression/anxiety (PHQ-4). Odd ratios were calculated to examine the association between CM and diabetes, and mediation analyses including PHQ-4 as covariate were conducted to examine the role of personality functioning.

Results: All CM types significantly elevated the odds of having diabetes in adulthood. Personality functioning mediated the association between abuse and diabetes (sexual: b= 0.012, 95% CI [.002, 0.022],
PM = 25.0%, physical: b= 0.009, 95% CI [.001, 0.017], PM = 12.0%, and emotional: b= 0.013, 95% CI [.002, 0.024], PM = 59.8%), but not between neglect and diabetes.

Conclusions: CM is associated with an increased risk of diabetes, with personality functioning being a relevant mediator for CM abuse types. Hence, by focusing on CM prevention and considering impaired
personality functioning in diabetes treatment, diabetes self-management and health behavior could be improved.