ArticlePloS one2017
Stress increases the risk of type 2 diabetes onset in women: A 12-year longitudinal study using causal modelling.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers.
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Who cites it
53 citing papers in PubMed, 126 citations in OpenAlex.
- Voice changes associated with stress and distress in people living with diabetes: Results from the Colive Voice study.PLOS digital health · 2026Article
- Machine learning used to study risk factors for chronic diseases: A scoping review.Canadian journal of public health = Revue canadienne de sante publique · 2026Article
- Review
- Associations between perceived stress and glycemic measures: gender and age as moderators.BMJ open diabetes research & care · 2025Observational
- Citywide park renovations and changes in perceived stress: a quasi-experimental study among low-income communities in New York City.BMC public health · 2025Article
- The impact of academic stress on the lifestyle of university students in Kuwait.BMC public health · 2025Article
- Perceived Stress, Perceived Social Support, and Global Health in Adults with Chronic Pain.International journal of behavioral medicine · 2025Article
- Unveiling inequalities: Racial, ethnic, and socioeconomic disparities in diabetes: Findings from the 2007-2020 NHANES data among U.S. adults.Preventive medicine reports · 2025Article
- Structural analysis of social behavior: Using cluster analysis to examine personality profile associated with diabetes onset.PloS one · 2025Article
- Effects of combined aerobic-resistance training on health-related quality of life and stress in sedentary adults.Frontiers in aging · 2025Article
- Article
- Prospective associations between psychosocial stress and the risk of type 2 diabetes in middle-aged adults: findings from the KoGES_CAVAS.Epidemiology and health · 2025Article
- A prospective cohort study of persistent endocrine-disrupting chemicals and perceived stress.American journal of epidemiology · 2024Article
- Increases in Psychological Stress Are Associated With Higher Fasting Glucose in US Chinese Immigrants.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2024Article
- The Role of Insulin Within the Socio-Psycho-Biological Framework in Type 2 Diabetes-A Perspective from Psychoneuroimmunology.Biomedicines · 2024Review
- Perceived stress and associations between physical activity, sedentary time, and interstitial glucose in healthy adolescents.Physiology & behavior · 2024Article
- The association of physical activity and leisure-time sedentary behavior with perceived stress among Chinese adults: A cross-sectional study based on the Chinese health and nutrition survey data.Preventive medicine reports · 2024Article
- Great leap forward famine exposure and urban-rural migration convolute the modern prevalence of diabetes in China.Journal of health, population, and nutrition · 2024Article
- Sadness-Based Approach-Avoidance Modification Training for Subjective Stress in Adults: Pilot Randomized Controlled Trial.JMIR formative research · 2023Article
- Lifetime Interpersonal Violence or Abuse and Diabetes Rates by Sex and Race.American journal of preventive medicine · 2023Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundType 2 diabetes is associated with significant morbidity and mortality. Modifiable risk factors have been found to contribute up to 60% of type 2 diabetes risk. However, type 2 diabetes continues to rise despite implementation of interventions based on traditional risk factors. There is a clear need to identify additional risk factors for chronic disease prevention. The aim of this study was to examine the relationship between perceived stress and type 2 diabetes onset, and partition the estimates into direct and indirect effects. METHODS AND
findingsWomen born in 1946-1951 (n = 12,844) completed surveys for the Australian Longitudinal Study on Women's Health in 1998, 2001, 2004, 2007 and 2010. The total causal effect was estimated using logistic regression and marginal structural modelling. Controlled direct effects were estimated through conditioning in the regression model. A graded association was found between perceived stress and all mediators in the multivariate time lag analyses. A significant association was found between hypertension, as well as physical activity and body mass index, and diabetes, but not smoking or diet quality. Moderate/high stress levels were associated with a 2.3-fold increase in the odds of diabetes three years later, for the total estimated effect. Results were only slightly attenuated when the direct and indirect effects of perceived stress on diabetes were partitioned, with the mediators only explaining 10-20% of the excess variation in diabetes.
conclusionsPerceived stress is a strong risk factor for type 2 diabetes. The majority of the effect estimate of stress on diabetes risk is not mediated by the traditional risk factors of hypertension, physical activity, smoking, diet quality, and body mass index. This gives a new pathway for diabetes prevention trials and clinical practice.
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