Psychological Distress and Incidence of Type 2 Diabetes in High-Risk and Low-Risk Populations: The Whitehall II Cohort Study
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OBJECTIVE: We examined whether psychological distress predicts incident type 2 diabetes and if the association differs between populations at higher or lower risk of type 2 diabetes. RESEARCH DESIGN AND METHODS: This was a prospective cohort of 5,932 diabetes-free adults (4,189 men and 1,743 women, mean age 54.6 years) with three 5-year data cycles (1991–2009): a total of 13,207 person-observations. Participants were classified into four groups according to their prediabetes status and Framingham Offspring Type 2 Diabetes Risk Score: normoglycemia with a risk score of 0–9, normoglycemia with a risk score of 10–19, prediabetes with a risk score of 10–19, and prediabetes with a risk score of >19. Psychological distress was assessed by the General Health Questionnaire. Incident type 2 diabetes was ascertained by 2-h oral glucose tolerance test, doctor diagnosis, or use of antihyperglycemic medication at the 5-year follow-up for each data cycle. Adjustments were made for age, sex, ethnicity, socioeconomic status, antidepressant use, smoking, and physical activity. RESULTS: Among participants with normoglycemia and among those with prediabetes combined with a low risk score, psychological distress did not predict type 2 diabetes. Diabetes incidence in these groups varied between 1.6 and 15.6%. Among participants with prediabetes and a high risk score, 40.9% of those with psychological distress compared with 28.5% of those without distress developed diabetes during the follow-up. The corresponding adjusted odds ratio for psychological distress was 2.07 (95% CI 1.19–3.62). CONCLUSIONS: These data suggest that psychological distress is associated with an accelerated progression to manifest diabetes in a subpopulation with advanced prediabetes.
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Another study detected an association between psychological distress and new onset diabetes mellitus only in a subset of participants at high risk of T2DM at baseline.
“Another study only detected the association in a subset of participants who had a high risk of developing T2DM at baseline 76”
From Type 2 diabetes mellitus and psychological stress — a modifiable risk factor (2017) · cites this paper as [76]
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- Authors
- Virtanen, M., Ferrie, J. E., Tabak, A. G., Akbaraly, T. N., Vahtera, J., Singh-Manoux, A., & Kivimäki, M.
- Affiliations
- Finnish Institute of Occupational Health (FI)
- University of Bristol (GB)
- Department of Epidemiology and Public Health, University College, London, U.K.
- Inserm (FR)
- University of Turku (FI)
- Corresponding author
- Virtanen, Marianna
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2014-07-12
- Volume
- 37
- Issue
- 8
- Pages
- 2091-2097
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC4113169
- OpenAlex
- W2153429628
- Cited by
- 65
- References
- 38
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 7 · 2017: 9 · 2016: 7 · 2015: 4 · 2014: 1
- FWCI
- 5.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Semmelweis University Repository (Semmelweis University) (submittedVersion)
- Funders
- British Heart Foundation (RG/13/2/30098)
- Medical Research Council (MR/K013351/1)
- Economic and Social Research Council (ES/J023299/1)
- National Institute on Aging (R01AG034454, R01AG013196)
- National Heart, Lung, and Blood Institute (R01HL036310)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- psychological distress, type 2 diabetes, prediabetes, diabetes risk score, diabetes incidence, vulnerable populations, Whitehall II cohort
- MeSH terms
- Adult, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Humans, London, Male, Middle Aged, Prediabetic State, Prospective Studies, Risk Factors, Social Class, Stress, Psychological, Cohort Studies, Incidence, Disease Progression
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