PSYCHOLOGICAL STRESS AND LONG-TERM RISK OF TYPE 2 DIABETES MELLITUS AMONG CIVIL SERVANT: A PROSPECTIVE COHORT STUDY
Background:The high incidence rate of Diabetes Mellitus (DM) among Indonesian productive age populationsignificantly affects the quality of the human capital in this country. Thus, it is highly necessary to manage and to prevent the onset of DM by identifying its risk factors, both direct and indirect ones. One of these factors is psychological stress, which triggers increased level of the body's fight-or-flight hormone making the body release extra energy in the form of glucose and fat into cells. The long term psychological stress prevents the insulin fromenabling the extra energy to be absorbed into the cells thereby leading the glucose to build up in the blood. Therefore, it is important to identify the psychological stress in the attempt to avoid the future incidence of DM. Objective: To determine the association between psychological stress and risk of type 2 DM among male and female civil servants. Methods: A prospective cohort study was conductedin 190 participants (aged 26-45 years) of six civil department services in Bukittinggi city, West Sumatra Indonesia. Data were collected for 3 times measurements by using Depression, Anxiety, Stress Scale (DASS)and Framingham Offspring Type 2 Diabetes Risk Score (FRS). The Spearman rho was used to analyze the inferential statistic. Results: Result of the study showed there was a strong relationship between psychological stress and the risk of type 2 DM at baseline (RR = 0.46 , p< .05) and the coefficient of determinant showed 22%. Same as on 2nd and 3rd measurements were found that the p-values are < .05, while the determinant coefficient were 33% and 19%, respectively. Conclusion: The evidence reflected that a long term stress or uncontrol psychological stress for a sufficiently long period might disturb insuline regulation in the body, which in turn increases the risk of developing type 2 DM, especially on productive aged.