The Impact of Stressful Life Events on the Incidence of Type 2 Diabetes in U.S. Adults from the Health and Retirement Study.

Objectives: We evaluated the association between cumulative stressful life events (SLE) and type of stress (lifetime vs. recent) and incident diabetes (T2DM) in middle-aged U.S. adults.

Methods: Data from the 2006-2014 waves of the Health and Retirement Study (HRS) were analyzed (n = 7956). Stress-related differences in age at T2DM diagnosis were estimated using Cox proportional hazards models.

Results: The adjusted risk of T2DM significantly increased by six percent per unit increase in cumulative SLE (95% CI = 1.03, 1.11), by five percent per unit increase in lifetime stress (95% CI = 1.00, 1.09), and by 23% per unit increase in recent stress (95% CI = 1.12, 1.36). Each level of cumulative SLE (one, two, three, and > four events) and recent stress (one and > two events) compared to no stress was significantly associated with an increased risk of T2DM. Each level of lifetime stress compared to no stress was significantly associated with an elevated risk of T2DM except for three events.

Discussion: Cumulative SLE and type of stress were associated with incident T2DM in middle-aged adults. Reducing the direct effect of stress with management interventions may reduce the indirect effect of developing T2DM and warrants further investigation.