Work Stress, Sense of Coherence, and Risk of Type 2 Diabetes in a Prospective Study of Middle-Aged Swedish Men and Women

OBJECTIVE: To investigate the prospective influence of work stress on type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS: This population-based cohort included 3,205 women and 2,227 men, aged 35-56 years, with baseline normal glucose tolerance measured with oral glucose tolerance test. At follow-up 8-10 years later, T2D was diagnosed in 60 women and 111 men. Work stress factors evaluated by questionnaire (i.e., demands, decision latitude, job strain, shift work, overtime work, and also sense of coherence) were studied in association with T2D. Odds ratios (ORs) and 95% CIs adjusted for age, education, BMI, physical activity, smoking, family history of diabetes, and psychological distress were calculated. RESULTS: In women, low decision latitude was associated with T2D on its own (OR 2.4 95% CI 1.1-5.2) and combined with high demands: job strain (OR 4.2 2.0-8.7), adjusted for all available potential confounders. Also, shift work increased the risk of T2D in women (OR 2.2 1.0-4.7) when adjusted for age, education, and psychological distress, although this risk was diluted after multifactor adjustment (OR 1.9 0.8-4.4). In men, high work demands and high strain decreased the risk of T2D (OR 0.5 0.3-0.9) for both measures, as did an active job (high demands and high decision latitude, OR 0.4 0.2-0.9). CONCLUSIONS: Work stress and shift work may contribute to the development of T2D in women. In men, the risk was decreased by high work demands, high strain, and an active job.