2995-LB: Association between Diabetes Mellitus Incidence and Stressful Life Events, Perceived Stress, and Problematic Anger among Post 9/11 Military Veterans in the Millennium Cohort Study

Introduction and Objective: While it is plausible that psychological factors are causally related to type 2 diabetes (T2D), findings have been inconsistent. The aims of this study were to evaluate associations between stressful life events, perceived stress in the domains of health, work, finances, and relationships, and problematic anger and T2D incidence in post 9/11 military veterans. Methods: We identified members of the Millennium Cohort Study, an ongoing longitudinal study of military personnel, who had separated from the military and were T2D-free at study baseline. There were four exposures of interest: (1) stressful life events; (2) perceived health, work, and financial stress; (3) perceived relationship stress; and (4) problematic anger; separate subcohorts were created for each. T2D was identified based on VA electronic health record data or survey self-report. We employed a Cox proportional hazards model to compare T2D incidence rates across exposure groups in models that adjusted for demographic characteristics, depression, PTSD, sleep duration, combat deployment, and BMI. Results: About half of participants were 40 years and 68% were male, depending on the subcohort (from n=24,950 for the problematic anger subcohort to 36,059 for perceived relationship stress subcohort). Incidence of new-onset T2D was between 11.2 and 11.8 cases/1000 person-years. When unadjusted, each exposure was associated with an increased risk of T2D. When adjusted for all covariates, T2D risks remained elevated for stressful life events (HR=1.09, 95% CI 1.01-1.17 for 1 vs. none; HR=1.26, 95% CI 1.15-1.37 for 2+ vs. none) and perceived health-work-finances stress (continuous: HR=1.04, 95% CI 1.03-1.06) but not perceived relationship stress or problematic anger. Conclusion: Stressful life events and perceived stress related to health, work, and finances were associated with a higher risk of T2D in a mainly working age population. Disclosure A. Littman: None. A. Jeon: None. A.C. Peterson: None. A. Baraff: None. E.L. Richard: None. S.F. Castaneda: None. S. Mohazzab-Hosseinian: None. M.J. Trejo: None. E. Boyko: None. Funding Defense Health Agency, Defense Health Program, and Department of Veterans Affairs (Office of Research and Development, Health Outcomes Military Exposures) under work unit no. 60002.VA Cooperative Studies Program #505