Teenage boys who suffer from stress are more likely to develop diabetes in later life, warns new research.
The study, published in the journal Diabetologia, shows that low resistance to stress at the age of 18 can increase the risk of type 2 diabetes in adulthood by up to 50 per cent.
Stress in adulthood is associated with a higher risk of type 2 diabetes, possibly mediated by behavioural and physiological factors.
But it is not known whether low stress resilience earlier in life is related to subsequent development of type 2 diabetes.
In the new study, researchers examined whether low stress resilience in late adolescence is associated with an increased risk of type 2 diabetes in adulthood.
They looked at all 1,534,425 military conscripts in Sweden from 1969 to 1997, covering a period when national service was compulsory in Sweden and including 97 to 98 per cent of all 18-year-old men nationwide each year.
To be included, the men had to have no previous diagnosis of diabetes. They underwent standardised psychological assessment for stress resilience, on a scale of one to nine, and were checked for type 2 diabetes, identified from outpatient and inpatient diagnoses from 1987 to 2012.
A total of 34,008 men were found to have been diagnosed with type 2 diabetes in 39 million person-years of follow-up.
Low stress resilience was associated with an increased risk of developing type 2 diabetes after adjusting for body mass index (BMI), family history of diabetes, and individual and neighbourhood socio-economic factors.
The 20 per cent of men with the lowest resistance to stress were 51 per cent more likely to have been diagnosed with diabetes than the 20 per cent with the highest resistance to stress, with diabetes risk decreasing in a roughly linear fashion with increased resistance to stress.
The researchers suggest that the mechanisms by which stress resilience may influence the development of type 2 diabetes are probably complex and involve unhealthy lifestyle behaviours as well as other physiological factors.
People who are more stressed are more likely to exhibit unhealthy behaviours such as smoking, unhealthy diet and lack of physical activity, and it could be these behaviours that form most of or part of the increased risk of diabetes found in men with lower stress resistance.
The researchers also noted that since the study was only of male army recruits, it is not certain whether the findings apply directly to women.
Study lead author Dr Casey Crump, of Stanford University in the United states, said: “These findings suggest that psychosocial function and ability to cope with stress may play an important long-term role in aetiological pathways for type 2 diabetes.
“Additional studies will be needed to elucidate the specific underlying causal factors, which may help inform more effective preventive interventions across the lifespan.”