title: Self-Perceived Emotional Distress and Diabetes Risk Among Young Men.
abstract: There are mixed data regarding the effect of emotional distress on diabetes risk, especially among young adults. This study assessed the effect of self-perceived emotional distress on diabetes incidence among young men.
  
  
  
  Incident diabetes during a mean follow-up of 6.3 (4.3) years was assessed among 32,586 men (mean age, 31.0 [5.6] years) of the Metabolic, Lifestyle, and Nutrition Assessment in Young Adults cohort with no history of diabetes between 1995 and 2011. Emotional distress was assessed by asking participants as part of a computerized questionnaire: Are you preoccupied by worries or concerns that affect your overall wellbeing? Time-dependent Cox models were applied. Data analysis took place between 2014 and 2015.
  
  
  
  There were 723 cases of diabetes during 206,382 person-years. The presence of distress was associated with a 53% higher incidence of diabetes (95% CI=1.08, 2.18, p=0.017) after adjustment for age, BMI, fasting plasma glucose, family history of diabetes, triglyceride and high-density lipoprotein cholesterol levels, education, cognitive performance, white blood cell count, physical activity, and sleep quality. These results persisted when distress, BMI, physical activity, and smoking status were treated as time-dependent variables (hazard ratio=1.66, 95% CI=1.21, 2.17, p=0.002). An adjusted hazard ratio of 2.14 (95% CI=1.04, 4.47, p=0.041) for incident diabetes was observed among participants persistently reporting emotional distress compared with those persistently denying it.
  
  
  
  Sustained emotional distress contributes to the development of diabetes among young and apparently healthy men in a time-dependent manner. These findings warrant awareness by primary caregivers when stratifying diabetes risk.
authors.affiliation: Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel; The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; The Israel Defense Forces Medical Corps, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: gilad.twig@gmail.com.
authors.forename: Gilad
authors.initials: G
authors.lastname: Twig
authors.affiliation: Division of Endocrinology and Metabolism, and Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.
authors.forename: Hertzel C
authors.initials: HC
authors.lastname: Gerstein
authors.affiliation: The Israel Defense Forces Medical Corps, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Fruchter
authors.affiliation: The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; The Israel Defense Forces Medical Corps, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Avi
authors.initials: A
authors.lastname: Shina
authors.affiliation: The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Ministry of Health, Jerusalem, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Afek
authors.affiliation: The Israel Defense Forces Medical Corps, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Estela
authors.initials: E
authors.lastname: Derazne
authors.affiliation: The Israel Defense Forces Medical Corps, Israel.
authors.forename: Dorit
authors.initials: D
authors.lastname: Tzur
authors.affiliation: The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Cukierman-Yaffe
authors.affiliation: The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Psychiatry B, Ness Ziona Mental Health Center, Ness Ziona, Israel.
authors.forename: Daniela
authors.initials: D
authors.lastname: Amital
authors.affiliation: Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel; The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Howard
authors.initials: H
authors.lastname: Amital
authors.affiliation: The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel; Department of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Amir
authors.initials: A
authors.lastname: Tirosh
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology*
chemical_list: D001786:Blood Glucose