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ContextProspective 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.MethodsData were collected from 1,463 white-collar workers followed for an average of 16 years. Effort-reward imbalance at work (ERI) was measured in 1999-2001 using a validated instrument. HbA1c was assessed at follow-up (2015-18) using the immunochemical method. 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 generalized linear models.ResultsIn women, those exposed to effort-reward imbalance at work had a higher prevalence of prediabetes (adjusted PR=1.5, 95% confidence interval: 1.0-2.3). 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 targeting these psychosocial stressors at work may be effective strategies to reduce the prevalence of prediabetes among women.

Objective:Previous literature suggests an association between psychosocial stressors at work (PSWs) and the risk of type 2 diabetes mellitus (T2DM). According to the demand-control model, the combination of high psychological demands at work and low levels of control is called job strain, which increases the risk of T2DM. Prediabetes greatly increases the risk of developing T2DM and is also independently associated with an increased mortality risk. However, the evidence regarding the association between PSWs and prediabetes is scarce. The objective of this study is to clarify the relationship between cumulative exposure to PSWs, defined according to the demandcontrolmodel, and both prediabetes prevalence in a longitudinal cohort.Design and method:Over 9000 white-collar workers (48.5% female) were recruited in 1991–1993 and were followed up 8 and 24 years later. Workers exposed to job strain at baseline and at the 8- year follow-up were considered exposed to chronic job strain. Glycated hemoglobin (HbA1c) was measured at the 24-year follow-up in 1461 workers and was used to measure prediabetes prevalence. Odds ratios (ORs) were computed using multiple logistic regressions which were adjusted for potential confounding factors.Results:In female workers, chronic job strain was associated more than twice the odds of prediabetes (OR = 2.21, 95% CI 1.05–4.67) compared to unexposed workers, even after adjusting for sociodemographic factors and lifestyle habits. There was no association between job strain and prediabetes in male workers.Conclusion: Our results suggest that PSWs, when they are measured with the demand-control model, are associated with an increased prediabetes prevalence. Given the increasing burden of disease of prediabetes and T2DM in Canada and in other developed countries, addressing these frequent and modifiable occupational factors could improve the health of Canadian workers, especially female workers. Therefore, workplace interventions that aim to decrease adverse PSWs should be considered to reduce glucose metabolism imbalances at the population level.