Psychosocial Stress Predicts Abnormal Glucose Metabolism: The Australian Diabetes, Obesity and Lifestyle (AusDiab) Study
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ORIGINAL ARTICLE
Psychosocial Stress Predicts Abnormal Glucose Metabolism: The Australian Diabetes, Obesity and Lifestyle (AusDiab) Study Emily D. Williams, Ph.D. & Dianna J. Magliano, Ph.D. & Robyn J. Tapp, Ph.D. & Brian F. Oldenburg, Ph.D. & Jonathan E. Shaw, MD, FRACP, FRCP
Published online: 7 February 2013 # The Society of Behavioral Medicine 2013
Abstract Background The evidence supporting a relationship between stress and diabetes has been inconsistent. Purpose This study examined the effects of stress on abnormal glucose metabolism, using a population-based sample of 3,759, with normoglycemia at baseline, from the Australian Diabetes, Obesity and Lifestyle study. Methods Perceived stress and stressful life events were measured at baseline, with health behavior and anthropometric information also collected. Oral glucose tolerance tests were undertaken at baseline and 5-year follow-up. The primary outcome was the development of abnormal glucose metabolism (impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes), according to WHO 1999 criteria. Results Perceived stress predicted incident abnormal glucose metabolism in women but not men, after multivariate adjustment. Life events showed an inconsistent relationship with abnormal glucose metabolism. E. D. Williams (*) : B. F. Oldenburg School of Public Health and Preventive Medicine, Alfred Hospital, Monash University, 89 Commercial Road, Melbourne, VIC 3004, Australia e-mail: [email protected] E. D. Williams International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, UK D. J. Magliano : J. E. Shaw Baker IDI Heart and Diabetes Institute, Melbourne, Australia R. J. Tapp National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
Conclusions Perceived stress predicted abnormal glucose metabolism in women. Healthcare professionals should consider psychosocial adversity when assessing risk factor profiles for the development of diabetes. Keywords Type 2 diabetes . Stress . Risk factors . Prevention . Health behaviors
Introduction The prevalence of diabetes is rising rapidly worldwide, with projections estimating that there will be up to 439 million people globally living with diabetes by 2030 [1]. Considerable research has confirmed biological and behavioral variables as risk factors for the development of type 2 diabetes [2]. However, the role of psychosocial risk factors, including psychological characteristics, social relationships, and stressors, in the development of diabetes has received much less attention. Despite the established link between psychosocial adversity and the development of coronary heart disease (CHD) [3, 4], and the fact that there is significant overlap in risk factors and underlying pathology between diabetes and CHD [5], the role of psychosocial risk factors remains under-researched in the diabetes field. The previous work in this area has shown that psychological characteristics, such as depression and psychological distress (
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