The Impact of Stressful Life Events on the Incidence of Type 2 Diabetes in US 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 (Type 2 diabetes mellitus [T2DM]) in middle-aged U.S. adults. Methods Data from the 2006-2014 waves of the Health and Retirement Study (HRS) were analyzed (n = 7,956). Stress-related differences in age at T2DM diagnosis were estimated using Cox proportional hazards models. Results The adjusted risk of T2DM significantly increased by 6% per unit increase in cumulative SLE (95% confidence interval [CI] = 1.03, 1.11), by 5% 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 (1, 2, 3, and >= 4 events) and recent stress (1 and >= 2 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 3 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.