March 13, 2019
2 min read

Mentally tiring work increases type 2 diabetes risk in women

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A cohort of French women who reported having jobs with mentally tiring work were 21% more likely to develop type 2 diabetes during 2 decades of follow-up vs. women who reported working in fields that were not mentally tiring, according to findings from an observational study published in the European Journal of Endocrinology.

The association between mentally tiring work and diabetes risk, according to researchers, remained stable after adjusting for most known potential confounders and was found in sensitivity analyses to be restricted to women without overweight or obesity.

Guy Fagherazzi

“In this study on more than 70,000 women followed for 22 years, we have observed an increased risk of type 2 diabetes associated with mentally tiring work, used as a marker of job demands,” Guy Fagherazzi, MSc, PhD, HDR, senior research scientist in digital and diabetes epidemiology at the Center of Research in Epidemiology and Population Health at Paris-Saclay University, told Endocrine Today. “Women with very mentally tiring work have a 21% higher risk for developing type 2 diabetes than women with little or not mentally tiring work.”

Fagherazzi and colleagues analyzed data from 73,517 women (predominantly teachers) from the E3N cohort, a French prospective study of women born between 1925 and 1950 (mean age, 51 years). Participants completed biennial self-administered questionnaires through November 2014 and allowed for the sharing of health insurance plan data, including all outpatient reimbursements for health expenditures since January 2004. Information on mentally tiring work was collected in a 1992 questionnaire and was used as a validated proxy for work-related psychological demands. Participants were asked, “Do you (or did you) find your work mentally tiring?” Responses included “little or not mentally tiring,” “mentally tiring” and “very mentally tiring.” Researchers used Cox regression models to estimate HRs for type 2 diabetes risk based on level of mentally tiring work.

At baseline (1992 questionnaire), 17,697 women (24%) reported work that was very mentally tiring, 42,198 women (57.4%) reported mentally tiring work and 13,622 women (18.53%) reported having little or not mentally tiring work.

In the overall population, women reporting very mentally tiring work were 21% more likely to develop type 2 diabetes during follow-up vs. women who reported little or not mentally tiring work (HR = 1.21; 95% CI, 1.09-1.35). Results persisted after adjustment for age, level of education, current activity status, most recent profession, recreational physical activity level, BMI, smoking status and family history of diabetes.


In analyses stratified by BMI, researchers found that the association between very mentally tiring work and type 2 diabetes was significant only for women with a BMI of less than 25 kg/m² (HR = 1.26; 95% CI, 1.08-1.47). In women with a BMI of at least 25 kg/m², researchers observed only a modest increased risk (HR = 1.14; 95% CI, 0.98-1.32).

There was no interaction between mentally tiring work and family history of diabetes or profession, according to researchers.

“Our results suggest the importance of taking into consideration the potential long-term metabolic impact of work-related stress for women working in a demanding environment,” Fagherazzi said. “We will now run studies focusing on the effect of stress and psychological factors on diabetes-related complications in patients with type 1 and type 2 diabetes. Increased support for individuals with demanding jobs should also be investigated in intervention studies.” – by Regina Schaffer

For more information:

Guy Fagherazzi, MSc, PhD, HDR, can be reached at the Center of Research in Epidemiology and Population Health, Inserm U1018, Paris-South, Paris-Saclay University; email:

Disclosures: The authors report no relevant financial disclosures.