Biopsychosocial Pathways to Prediabetes and Diabetes

Type 2 diabetes is a significant problem worldwide, accounting for substantial morbidity and premature mortality. Understanding why some people remain healthy while others progress to insulin resistance and diabetes requires an integrative approach. Models of diabetes have focused on excess weight and physical inactivity as key targets for reducing diabetes risk. Obesity is a risk factor for developing Type 2 diabetes, yet most obese persons do not develop diabetes, suggesting moderation by other influences. This chapter highlights Midlife in the United States studies that employed multidomain assessments of the interplay between established risk factors and psychosocial influences on diabetes. The chapter reviews evidence that depression, anger, perceived weight discrimination, and neuroticism exacerbate the association between obesity and diabetes. The conclusion that psychosocial processes are major risk factors underscores the need for assessing mental health and promoting psychological well-being to complement traditional prevention efforts.