Being exposed to workplace bullying and violence may increase the risk of developing type 2 diabetes, for both men and women, according to researchers from Scandinavia.
They noted that previous studies had found issues, such as job insecurity and long working hours, with consequent psychological impacts, were associated with a moderately higher risk of diabetes.
“There is a moderate and robust association between workplace bullying, violence and the development of type 2 diabetes”
It had also been shown before that bullying and violence can affect personal resources, such as self-esteem and the ability to cope, highlighted the researchers from Denmark Sweden and Finland.
For their study, they analysed data from four existing population studies involving a total of 19,280 men and 26,625 women, aged 40 to 65 years.
Specifically, they looked for exposure to workplace violence or threats of violence over the previous 12 months and workplace bullying – defined as unkind or negative behaviour from colleagues.
They found 9% of the participants reported exposure to workplace bullying and over a follow up period of 11.7 years, 1,223 new cases of type 2 diabetes were identified among this group.
After adjustment, being bullied at work was associated with a 46% higher risk of type 2 diabetes –61% for men and 36% for women.
Alcohol consumption and mental health difficulties did not affect the link but adjustment for body mass index removed one-third of the risk increase, noted the researchers.
“Being bullied is regarded as a severe social stressor that may activate the stress response”
Meanwhile, around 12% of participants had experienced violence or threats of violence in the preceding 12 months, among which 930 developed diabetes during a mean follow up of 11.4 years.
After adjusting for confounders, workplace violence was associated with a 26% higher risk of diabetes, for both men and women. Again, alcohol and mental health did not affect the finding.
The researchers said: “There is a moderate and robust association between workplace bullying, violence and the development of type 2 diabetes.
“As both bullying and violence or threats of violence are common in the workplace, we suggest that prevention policies should be investigated as a possible means to reduce this risk,” they stated.
The study authors also highlighted that, while bullying and violence both represented negative interpersonal relationships, they were different and should be viewed as distinct social stressors.
They noted that bullying was characterised by psychological aggression, such as unfair criticisms, isolation and humiliating work tasks, and was most often perpetrated by colleagues or managers.
Violence, on the other hand, involved physical acts such as pushing or kicking, or the threat of them, and was generally perpetrated by people from the outside, such as clients or patients.
Depression in nurses ‘increases likelihood of making errors’
As a result, bullying and violence should be seen as distinct behaviours and consequently their induced emotions can be different, said the researchers.
They suggested that changes caused by stress hormones may be one possible causal pathway linking bullying, violence and diabetes.
In addition, they said metabolic changes and obesity may be a mechanism, as the stress response might alter the endocrine regulation of appetite or negative emotions might induce comfort eating.
“Being bullied is regarded as a severe social stressor that may activate the stress response and lead to a range of downstream biological processes that may contribute towards the risk of diabetes,” said the study authors.
“Further study of possible causal pathways, for example weight gain, negative emotions and the psychological stress response, would help to provide an understanding of the causal mechanisms and to develop cost effective interventions,” they added.
The findings have been published in Diabetologia, the journal of the European Association for the Study of Diabetes.