Being exposed to workplace violence may increase the risk of developing type 2 diabetes, for both men and women.

New research shows that bullying and violence can affect personal resources, such as self-esteem and the ability to cope.

Researchers from Denmark, Sweden and Finland analyzed 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 behavior 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.

Around 12% of participants 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.

Workplace violence was associated with a 26% higher risk of diabetes, for both men and women.

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 stressers.

They noted that bullying was characterized by psychological aggression, such as unfair criticisms, isolation and humiliating work tasks, and was most often perpetrated by colleagues or managers.

Violence 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.

“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.