Men who have low resistance to psychological stress at age 18 may face considerably higher risk for type 2 diabetes in adulthood compared to those better able to handle stress, according to new research.
"Other studies have found that stressful life experiences in mid-adulthood are linked with a higher risk of developing diabetes," said lead author Dr. Casey Crump of the Mount Sinai School of Medicine in New York.
But none have looked at whether responses to stress at a young age predict risk of diabetes much later in life, Crump and his colleagues write in Diabetologia.
"Stress resilience refers to the ability to properly adapt to or cope with stress and adversity," Crump, who was at Stanford University in California when he worked on the study, told Reuters Health by email. "Low resistance to stress (or low stress resilience) means difficulty coping with or rebounding from adversity."
The study team analyzed data on more than 1 million 18-year-old men who were conscripted into military service in Sweden between 1969 and 1997, when service was compulsory.
The young men did not have diabetes at age 18 and all underwent standard psychological assessments of their stress resistance. In a 20 to 30 minute interview, a psychologist asked each man about adjustment problems and conflicts, successes, responsibilities taken on and initiatives shown or experienced in school, work, home or in leisure activities.
Crump's team matched the participants to their later medical records to see who received an outpatient or inpatient diagnosis of diabetes between 1987 and 2012. About 34,000 of the men were diagnosed with type 2 diabetes.
After accounting for body weight, family history of diabetes and individual and neighborhood socioeconomic factors, the researchers found that men with low stress resilience - that is, with a score between one and three on a nine-point scale - were 51 percent more likely to have a diabetes diagnosis than those with the highest scores, between seven and nine.
"Both the amount of stress and stress resilience may have important health effects," Crump said. "Common sources of stress include relationship, family, school, and workplace problems or worries."
People who experience a lot of stress or have trouble resisting it may react with unhealthy behaviors like poor eating habits, little physical activity and smoking or heavier alcohol use, he said.
"Other stress-related physiologic changes may also be involved, such as higher levels of (the stress hormone) cortisol which can contribute to insulin resistance and diabetes," he said.
"If you have low stress resilience, even some everyday experiences can be stressful," said Dr. Cecilia Bergh of Orebro University in Sweden, who was not part of the new study. "Very high levels of stress, such as being in a war zone, are damagingly stressful for almost everybody, even among those with high stress resilience," Bergh told Reuters Health by email.
The general public, and especially those who are overweight or have a family history of diabetes, should know that stress management is an important part of maintaining long-term health and preventing diabetes, Crump said.