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Diabetes Care. 2014 Aug;37(8):2091-7. doi: 10.2337/dc13-2725. Epub 2014 May 1.

Psychological distress and incidence of type 2 diabetes in high-risk and low-risk populations: the Whitehall II Cohort Study.

Author information

1
Finnish Institute of Occupational Health, Helsinki, Finland marianna.virtanen@ttl.fi.
2
Department of Epidemiology and Public Health, University College, London, U.K.School of Community and Social Medicine, University of Bristol, Bristol, U.K.
3
Department of Epidemiology and Public Health, University College, London, U.K.1st Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
4
Institut National de la Santé et de la Recherche Médicale, U1061, Montpellier, France.
5
Finnish Institute of Occupational Health, Helsinki, FinlandUniversity of Turku and Turku University Hospital, Turku, Finland.
6
Department of Epidemiology and Public Health, University College, London, U.K.Institut National de la Santé et de la Recherche Médicale, U1018, Paris, France.
7
Department of Epidemiology and Public Health, University College, London, U.K.

Abstract

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.

PMID:
24784831
PMCID:
PMC4113169
DOI:
10.2337/dc13-2725
[Indexed for MEDLINE]
Free PMC Article

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