Perceived stress and incidence of Type 2 diabetes: a 35‐year follow‐up study of middle‐aged Swedish men
Abstract
Aim: To explore incident cases of diagnosed diabetes over 35 years of follow‐up in relation to self‐perceived stress at baseline. Methods: This was a population‐based random sample of 7251 men derived from the Primary Prevention Trial Study, aged 47–56 years at baseline and without prior history of diabetes, coronary heart disease and stroke. Incident diabetes was identified from hospital discharge and death registries as principal or secondary diagnosis. Cox proportional hazards regression was used to evaluate the potential association between stress and diabetes. Results: During a 35‐year follow‐up, a total of 899 men were identified with diabetes. The crude incidence was 5.2 per 1000 persons‐years. At baseline, 15.5% men reported permanent stress related to conditions at work or home. After adjusting for age and competing risk of death, the estimated 35‐year conditional probability of diabetes in men with permanent stress was 42.6%, compared with 31.0% for those with periodic stress and 31.2% with no stress. In age‐adjusted Cox regression analysis, men with permanent stress had a higher risk of diabetes [hazard ratio 1.52 (95% CI 1.26–1.82)] compared with men with no (referent) or periodic stress [hazard ratio 1.09 (95% CI 0.94–1.27)]. The association between stress and diabetes was slightly attenuated but remained significant after adjustment for age, socio‐economic status, physical inactivity, BMI , systolic blood pressure and use of anti‐hypertensive medication [hazard ratio 1.45 (95% CI 1.20–1.75)]. When examining principal diagnosis of diabetes cases separately from secondary diagnoses cases, the excess risk of diabetes associated with permanent stress remained significant both in age (only) and multivariable adjusted models. Conclusion: Self‐perceived permanent stress is an important long‐term predictor of diagnosed diabetes, independently of socio‐economic status, BMI and other conventional Type 2 diabetes risk factors.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The association between perceived stress and T2DM varies by sex or socioeconomic status in some studies.
“However, this association has been shown in some studies to vary by sex or socioeconomic status (as measured by occupational status), which indicates that these factors might moderate this relationship.”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as [81]
A link exists between perceived stress and development of T2DM.
“Considering the evidence as a whole, a link seems to exist between perceived stress and development of T2DM.”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as [81]
In Swedish men (n=7,251; n=899 incident cases of diabetes mellitus; 35-year follow-up), perceived permanent stress (self-reported stress related to work or home life ongoing for >1 year) was associated with incident diabetes mellitus (HR 1.52, 95% CI 1.26-1.82).
“Swedish men ( n = 7,251; n = 899 incident cases of diabetes mellitus; 35 year follow-up) | Perceived permanent stress (self-reported stress related to work or home life ongoing for >1 year) | *HR 1.52 (95% CI 1.26-1.82).”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as Novak (2013) 74
Cites
O'Donnell, M. J., Xavier, D., Liu, L., Zhang, H., Chin, S. L., Rao-Melacini, P., Rangarajan, S., Islam, S., Pais, P., McQueen, M. J., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60834-3 · Cited by 3,448 · see citing works
Simulation Study of Confounder-Selection Strategies
Maldonado, G., & Greenland, S. (1993) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116813 · Cited by 2,491 · see citing works
Quantity and Quality of Sleep and Incidence of Type 2 Diabetes
Cappuccio, F. P., D'Elia, L., Strazzullo, P., & Miller, M. A. (2010) · Diabetes Care · doi:10.2337/dc09-1124 · Cited by 1,670 · see citing works
Depression and Type 2 Diabetes Over the Lifespan
Mezuk, B., Eaton, W. W., Albrecht, S., & Golden, S. H. (2008) · Diabetes Care · doi:10.2337/dc08-0985 · Cited by 1,558 · see citing works
Type 2 diabetes across generations: from pathophysiology to prevention and management
Nolan, C. J., Damm, P., & Prentki, M. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60614-4 · Cited by 923 · see citing works
Stress and Diabetes: A Review of the Links
Lloyd, C., Smith, J., & Weinger, K. (2005) · Diabetes Spectrum · doi:10.2337/diaspect.18.2.121 · Cited by 248 · see citing works
KATO, M., NODA, M., INOUE, M., KADOWAKI, T., & TSUGANE, S. (2009) · Endocrine Journal · doi:10.1507/endocrj.k09e-003 · Cited by 120 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Joseph, J. J., & Golden, S. H. (2017) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13217 · Cited by 574 · see citing works
Type 2 diabetes mellitus and psychological stress — a modifiable risk factor
Hackett, R. A., & Steptoe, A. (2017) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2017.64 · Cited by 480 · see citing works
Steptoe, A., Hackett, R. A., Lazzarino, A. I., Bostock, S., La Marca, R., Carvalho, L. A., & Hamer, M. (2014) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1410401111 · Cited by 167 · see citing works
Psychosocial Factors in Diabetes and Cardiovascular Risk
Hackett, R. A., & Steptoe, A. (2016) · Current Cardiology Reports · doi:10.1007/s11886-016-0771-4 · Cited by 152 · see citing works
Adverse Effects of Depression on Glycemic Control and Health Outcomes in People with Diabetes
Pouwer, F., Nefs, G., & Nouwen, A. (2013) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2013.05.002 · Cited by 132 · see citing works
Endocrine stress responses and risk of type 2 diabetes mellitus
Siddiqui, A., Madhu, S. V., Sharma, S. B., & Desai, N. G. (2015) · Stress · doi:10.3109/10253890.2015.1067677 · Cited by 68 · see citing works
Bossé, S., Stalder, T., & D'Antono, B. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000569 · Cited by 33 · see citing works
Self-Perceived Emotional Distress and Diabetes Risk Among Young Men
Twig, G., Gerstein, H. C., Fruchter, E., Shina, A., Afek, A., Derazne, E., Tzur, D., Cukierman-Yaffe, T., Amital, D., Amital, H., et al. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.12.006 · Cited by 6 · see citing works
- Authors
- Novak, M., Björck, L., Giang, K. W., Heden‐Ståhl, C., Wilhelmsen, L., & Rosengren, A.
- Affiliations
- University of Gothenburg (SE)
- Department of Molecular and Clinical Medicine the Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Corresponding author
- Novak, M.
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2012-12-13
- Volume
- 30
- Issue
- 1
- Pages
- e8-16
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W1983257463
- Cited by
- 114
- References
- 7
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 3 · 2023: 3 · 2022: 13 · 2021: 9 · 2020: 10 · 2019: 4 · 2018: 8 · 2017: 11 · 2016: 11 · 2015: 10 · 2014: 11 · 2013: 9
- FWCI
- 7.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Forskningsrådet för Arbetsliv och Socialvetenskap
- Vetenskapsrådet
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- perceived stress, type 2 diabetes, diabetes incidence, periodic stress, middle-aged men, long-term risk prediction, socioeconomic status, body mass index, hypertension, physical inactivity
- MeSH terms
- Diabetes Mellitus, Type 2, Follow-Up Studies, Humans, Male, Middle Aged, Perception, Risk Factors, Stress, Psychological, Sweden, Body Mass Index, Incidence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
