title: Work-related psychosocial stress and glycemic control among working adults with diabetes mellitus.
abstract: OBJECTIVE
  To examine the association between glycosylated hemoglobin (HbA1c) and four subscales of work-related psychosocial stress at study baseline and over time.
  
  
  METHODS
  We used survey data from a major HMO located in the Southeastern part of the US on health and healthy behaviors linked with patients' clinical, pharmacy and laboratory records for the period between 2005 and 2009. Study participants (n=537) consisted of working adults aged 25-59 years, diagnosed with diabetes mellitus (DM) but without advanced micro or macrovascular complications at the time of the survey. We estimated the baseline (2005) association between HbA1c and work-related psychosocial stress and their interactions using linear regression analysis. Using individual growth model approach, we estimated the association between HbA1c over time and work-related psychosocial stress. Each of the models controlled for socio-demographic variables, diet and physical activity factor, laboratory factor, physical examinations variables and medication use in a hierarchical fashion.
  
  
  RESULTS
  After adjusting for all study covariates, we did not find a significant association between work-related psychosocial stress and glycemic control either at baseline or over time.
  
  
  CONCLUSIONS
  Among fairly healthy middle aged working adults with DM, work-related psychosocial stress was not directly associated with glycemic control.
authors.affiliation: School of Public Health, Georgia State University, Atlanta, GA, United States. Electronic address: fannor1@gmail.com.
authors.forename: Francis B
authors.initials: FB
authors.lastname: Annor
authors.affiliation: School of Public Health, Georgia State University, Atlanta, GA, United States; Center for Health Research, Kaiser Permanente Georgia, Atlanta, GA, United States.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Roblin
authors.affiliation: School of Public Health, Georgia State University, Atlanta, GA, United States.
authors.forename: Ike S
authors.initials: IS
authors.lastname: Okosun
authors.affiliation: Department of Epidemiology, Emory University, Atlanta, GA, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Goodman
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control* / Q000523:psychology; D007003:Hypoglycemia / Q000517:prevention & control* / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D017132:Workplace
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Diabetes; Psychosocial stress; Stress; Stress at work place; Work environment