Abstract

Objective: To investigate the effect of psychosocial stress at work on risk of type 2 diabetes, adjusting for conventional risk factors, among a sample of British, white-collar, middle-aged men and women.

Research Design And Methods: Prospective analysis (1991-2004) from the Whitehall II cohort study. The current sample consists of 5895 Caucasian middle-aged civil servants free from diabetes at baseline. Type 2 diabetes was ascertained by an oral glucose tolerance test supplemented by self-reports at baseline and 4 consecutive waves of data collection including 2 screening phases. The job strain and iso-strain models were used to assess psychosocial work stress.

Results: Iso-strain in the workplace was associated with a 2-fold higher risk of type 2 diabetes in age-adjusted analysis in women but not men (Hazard Ratio 1.94: 95% Confidence Intervals 1.17; 3.21). This effect remained robust to adjustment for socioeconomic position and outside work stressors and was only attenuated by 20% after adjustment for health behaviours, obesity and other type 2 diabetes risk factors.

Conclusions: Psychosocial work stress was an independent predictor of type 2 diabetes among women after a 15-year follow-up. This association was not explained by potential confounding and mediating factors. More evidence from prospective studies using the same work stress models is needed to support the current findings and provide further evidence on gender differences.