Publication Type
Journal Article
Version
publishedVersion
Publication Date
11-2025
Abstract
Abstract
Introduction
Prediabetes presents an opportunity for early intervention. Growing evidence suggests that psychological stress may contribute to glucose dysregulation, but the findings are inconsistent.
This study aimed to clarify the association between perceived stress and glycemic measures, by first testing gender as a moderator, and then examining age as a moderator within each gender group.
Research design and methods
We analyzed cross-sectional data from 470 diabetes-free adults in Singapore. Participants completed the 10-item Perceived Stress Scale, comprising two subscales: perceived helplessness and perceived self-efficacy. Glycemic measures included fasting plasma glucose, glycated hemoglobin, and 2-hour plasma glucose (2h-PG) following an oral glucose tolerance test. Prediabetes was classified according to the American Diabetes Association diagnostic criteria.
Results
Multivariable regression analyses revealed significant moderating effects of gender on the relationship between perceived stress factors and both prediabetes status and 2h-PG levels. Specifically, higher perceived helplessness and perceived self-efficacy were significantly associated with a lower prevalence of prediabetes and lower 2h-PG levels among men. However, these associations were non-significant among women. Age significantly moderated the relationship between perceived helplessness (but not perceived self-efficacy) on prediabetes and 2h-PG levels in women; higher perceived helplessness was associated with a greater prevalence of prediabetes and higher 2h-PG levels among younger women.
Conclusions
Gender moderated the associations between perceived stress and both prediabetes prevalence and 2h-PG levels. Among women, age further moderated the association between perceived helplessness and these outcomes. Future research should consider both moderators. Tailored psychosocial stress management strategies may help reduce the prevalence of prediabetes and diabetes.
Keywords
Epidemiology, Psychological stress, Gender, Prediabetic state
Discipline
Industrial and Organizational Psychology | Personality and Social Contexts | Psychology | Social Psychology
Research Areas
Sociology
Publication
BMJ Open Diabetes Research & Care
Volume
13
Issue
6
First Page
1
Last Page
9
ISSN
2052-4897
Identifier
10.1136/bmjdrc-2025-005368
Publisher
BMJ Publishing Group
Embargo Period
12-26-2025
Citation
TSAI, Ming-Hong, GOH, Charlene Enhui, LEE, Michelle H., SEAH, Francine, LIM, Maybritte, FEBRIANA, Eveline, FU, Jiahui, YIP, Julie K., PRESHAM, Philip, & TOH, Sue-Anne Ee Shiow.(2025). Associations between perceived stress and glycemic measures: Gender and age as moderators. BMJ Open Diabetes Research & Care, 13(6), 1-9.
Available at: https://ink.library.smu.edu.sg/soss_research/4245
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Additional URL
https://doi.org/10.1136/bmjdrc-2025-005368
Included in
Industrial and Organizational Psychology Commons, Personality and Social Contexts Commons, Social Psychology Commons