Could Your Job Be Increasing Your Risk of Type 2 Diabetes? Study Sheds Light

Roles requiring high levels of emotional engagement and confrontation, such as those in healthcare, education, and public service, may significantly raise the risk of developing type 2 diabetes, according to a large-scale Swedish study published online in Occupational & Environmental Medicine. The findings suggest that emotional demands and difficult interactions in person-contact jobs, particularly when coupled with low workplace support, may have long-term metabolic consequences.

The study, led by researchers analyzing data from the Swedish Work, Illness, and Labour-market Participation cohort, drew on information from nearly 3 million adults aged 30–60 who were free of diabetes in 2005. Using job exposure matrices developed from Swedish Work Environment Surveys (1997–2013), the team assessed three stress-related dimensions of person-contact work: general contact with people, emotional demands (such as dealing with individuals in distress), and confrontation. Social support at work was also measured to determine its potential protective effect.

From 2006 to 2020, 216,640 individuals (60% men) in the study developed type 2 diabetes. High exposure to emotional demands and confrontation was associated with a 20% and 15% increased risk in men, and a 24% and 20% increased risk in women, respectively. For women, general contact with people initially showed a risk, but this disappeared after adjusting for job control.

The risk was significantly higher for workers with low levels of social support. Notably, women facing high emotional demands with low workplace support had a 47% greater risk of developing diabetes.

“With regards to having contact with people at work, there are expectations for emotional management where workers are required to express or hide emotions according to societal, occupational and organisational norms. It is especially stressful when the displayed emotion and the genuinely felt emotion are not aligned,” the authors noted. The biological mechanisms underlying the associations found may involve chronic stress that affects the neuroendocrine system, leading to excessive cortisol production, increased insulin resistance, and decreased insulin secretion and sensitivity, they suggest.

While the study has limitations—such as not accounting for individual experiences or lifestyle factors—the researchers emphasize the need to consider workplace emotional demands as a public health issue. Enhanced managerial and peer support, they suggest, could mitigate the physiological toll of these high-stress roles.

Reference: Pan K, Nevriana A, Almroth M, et al, Person-related work and the risk of type 2 diabetes: a Swedish register-based cohort study, Occupational and Environmental Medicine Published Online First: 24 June 2025. doi: 10.1136/oemed-2025-110088