Tuesday, November 6, 2018 (American Heart Association) – Traditional risk factors such as obesity, high blood pressure and sedentary lifestyle may not be the only predictors of type 2 diabetes. New research points on the role that can play stress in the development of the disease in women.
The study, presented on November 10 at the scientific American Scientific Association of Cardiology, found that the increase in stress due to traumatic episodes and long-term situations at home or at work was associated with a risk almost twice as much as new types of diabetes type 2 among older women.
"Psychosocial stressors and risk factors for diabetes should be taken as seriously as other diabetes risk factors," said Jonathan Butler, lead researcher and postdoctoral student at the University of California, the Adversity Studies Center and Cardiovascular Disease of San Francisco.
Diabetes is a major public health problem, affecting approximately 30.3 million Americans starting in 2015, according to the latest data from the Centers for Disease Control and Prevention. Among these people, 12 million are over 65 years old.
"As older women increasingly represent a greater proportion of our population, we need to better understand the risk factors for diabetes in this group," said Butler.
Diabetes is a chronic disease where the body can not regularly stain blood. Too much blood glucose can lead to a number of health problems, including heart disease, stroke and kidney disease. Although family history and age can play a role, factors such as high cholesterol, high blood pressure, obesity and physical inactivity make people more susceptible to type 2 diabetes.
However, researchers begin to look beyond physiological risk factors.
"We try to understand the relationship between stress, mental health and diabetes risk for a while," said Dr. Sherita Hill Golden, a professor of medicine at the Johns Hopkins University School of Medicine in Baltimore. Emerging evidence suggests that psychosocial stress and the way people face stress can affect cardiometabolic health.
Previous studies on stress and diabetes focused on individual stressors, such as work or the symptoms of depression or anxiety. Others only watch instantaneously in time. Thus, Butler and his colleagues set out to understand the joint relationship of multiple stressors with diabetes risk among women over time.
The researchers included data on 22,706 female health professionals who participated in the Women's Health Study that did not have heart disease and whose average age was 72 years. They collected information on acute and chronic stressors and then followed women for an average of three years. Acute stress included negative and traumatic life events, while chronic stress was related to work, family, relationships, finances, the neighborhood, and discrimination.
Women with the highest levels of acute and chronic stress almost doubled the risk of diabetes.
The next steps will be to confirm the results and identify strategies aimed at psychosocial stressors that can reduce the risk of diabetes in older women, Dr. Michelle A. Albert, senior author of the study and professor of medicine at the University of California, San Francisco.
"From a public health perspective, health care providers must investigate psychosocial stressors as part of their diabetes risk assessment," he said.
For now, Golden said the new research highlights the importance of considering the role of non-traditional risk factors, such as stress in the development of diabetes.
"We know lifestyle intervention works for the prevention of diabetes, but this can be a challenge if people experience cumulative stressors, such as losing a job or taking care of a family member, which prevents them from getting involved in healthy behaviors such as exercise, the right to eat or to quit smoking, "she said. "It is important to evaluate and understand the social history of a patient. Maybe they need a referral to a social worker or counselor."
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