Study Shows Job Stress Can Fuel Diabetes

The daily rigors of work, such as tight deadlines and long hours, can lead to job burnout, a state scientists are beginning to link with serious ailments.

Studies have shown that workplace stress can lead to an increase in rates of heart disease, flu virus, metabolic syndrome and high blood pressure.

One study found that stress can negate the heart-healthy aspects of a physically active job, leading to thicker arteries in physically active and stressed workers compared with active, non-stressed employees.

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A new study of 677 workers in Israel showed those who experienced job burnout were 1.8 times more likely to develop Type 2 diabetes, in which a person's body becomes resistant to the sugar-regulating hormone called insulin.

The results held even when factors like age, sex, exercise and obesity were taken into account.

Some studies have found stress can cause unhealthy behaviors, such as eating poorly or drinking more alcohol, which can then lead to health problems.

In the new study, the researchers suggest stress can have a more direct effect, disrupting the body's ability to process glucose, leading to diabetes.

The results show that burnout could boost the risk of illness by a "magnitude similar to other risk factors, such as high body mass index, smoking and lack of physical exercise," said study lead author Samuel Melamed of Tel Aviv University in Israel.

Job burnout

When work stress becomes unmanageable, job burnout can lead to a combination of three symptoms:

— emotional exhaustion

— physical fatigue or exhaustion

— cognitive weariness (slow thinking).

This state differs from a temporary malaise that passes after a period of rest. Causes of burnout include chronic stresses, such as lack of rewards, job insecurity, regular physical abuse and sexual harassment, as well as daily hassles and sudden traumas.

Work life

The scientists studied Israeli workers, who were apparently healthy initially, from 1998 to 2003. Nearly 77 percent of the workers were men, with an average age of 43 years.

The subjects had a range of occupations, which the scientists divided into five categories: senior management, middle management or supervisory — jobs like engineers, teachers and computer workers — nonprofessional and self-employed persons.

A burnout questionnaire revealed about half of the 677 subjects experienced high burnout. Of the workers, 17 developed Type 2 diabetes during the study period, with 3.2 percent of burned-out workers becoming diabetic compared with 1.8 percent of the other workers.

To figure out if the cause of diabetes was mediated by blood pressure, the researchers examined a subset of the subjects — 507 workers — for which they had tested for blood pressure.

The burned-out workers showed lower blood pressure levels, indicating that it was not hypertension — high blood pressure — causing diabetes.

An alternative explanation could be that stress triggers a spike in fatty acids in the blood and a drop in the "good" cholesterol, HDL — both factors associated with diabetes.

Stress factor

The job burnout may be only part of the picture, Melamed said.

"It is possible that these people are prone to diabetes because they can't handle stress very well," he said. "Their coping resources may have been depleted not only due to job stress but also life stresses, such as stressful life events and daily hassles."

Stress in general can disrupt the body's ability to process glucose, especially in people whose genetics make them vulnerable, said Richard Surwit of the Duke University Medical Center.

Surwit, who was not involved in the study, said the results should be replicated in a much larger group of subjects to see if the same results prevail.

The scientists suggest, in the November/December issue of the journal Psychosomatic Medicine, that the results confirm the need for effective interventions to reduce stress before it becomes burnout.

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