London civil servants at the lower end of the employment scale and with lower social position were more likely to develop type 2 diabetes than those at higher employment levels, according to an article in the September 27 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.
According to the article, recent studies have described a significant inverse relationship between impaired glucose tolerance (an indication of diabetes) and grade of employment in the civil service. Also, American adults with type 2 diabetes have less education and lower income than those without the disease. Psychosocial factors, such as having little control at work, low social support, depression and effort-reward imbalance (when high effort at work produces little reward or benefit), are established risk factors for coronary heart disease (CHD), which shares several common features with type 2 diabetes.
Meena Kumari, Ph.D., of University College London, and colleagues examined the relationship between social position and incidence of type 2 diabetes and whether psychosocial risk factors for CHD are associated with the onset of type 2 diabetes.
The researchers studied 10,308 civil servants aged 35 to 55 years during phase 1 of the Whitehall II Study (1985-1988). The Whitehall II study was established to examine relationships between social position, health, and death. Questionnaires were used to determine diabetes status at the beginning of the study and at phase 2 (1989), phase 3 (1992-1993), phase 4 (1995), and phase 5 (1997-1999), and glucose tolerance tests were administered at phase 3 and 4.