Effort-Reward Imbalance at Work, Glycated Hemoglobin and Prediabetes Prevalence in a Prospective Cohort

ContexProspective studies and meta-analyses suggest that psychosocial stressors at work from the effort-reward imbalance model are associated with an increased risk of type 2 diabetes mellitus (T2DM). Prediabetes is an intermediate disorder on the glucose metabolism continuum. It increases the risk of developing T2DM, while also being separately associated with increased mortality. Evidence about the effect of effort-reward imbalance at work on prediabetes is scarce. ObjectiveThe objective was to evaluate, in women and men, the association between effort-reward imbalance at work, glycated hemoglobin (HbA1c) concentration and the prevalence of prediabetes in a prospective cohort study. MethodsThis study was conducted among 1,354 white-collar workers followed for an average of 16 years. Effort-reward imbalance at work (ERI) was measured at baseline (1999-2001) using a validated instrument. HbA1c was assessed at follow-up (2015-18). Several covariates were considered including sociodemographics, anthropometric, and lifestyle risk factors. Differences in mean HbA1c concentration were estimated with linear models. Prediabetes prevalence ratios (PRs) were computed using Poisson regressions models. ResultsIn women, those exposed to effort-reward imbalance at work had a higher prevalence of prediabetes (adjusted PR=1.52, 95% confidence interval: 1.01-2.29). There was no difference in HbA1c concentration among those exposed and those unexposed to an effort-reward imbalance at work. ConclusionAmong women, effort-reward imbalance at work was associated with the prevalence of prediabetes. Preventive workplace interventions aiming to reduce the prevalence of effort-reward imbalance at work may be effective to reduce the prevalence of prediabetes among women.