Feelings of Loneliness in Older Adults Tied to Increase Risk of New-Onset Diabetes

Ruth Hackett, PhD

New research from King’s College London is shedding light on the relationship between social interaction and chronic illnesses, specifically the onset of type 2 diabetes.

Findings from the retrospective study, which included more than 4000 individuals, suggest a lack of quality connections with people, but not a lack of contact helped predict the onset of type 2 diabetes—highlighting the importance of social relationships during times like the ongoing pandemic.

“The study shows a strong relationship between loneliness and the later onset of type 2 diabetes. What is particularly striking is that this relationship is robust even when factors that are important in diabetes development are taken into account such as smoking, alcohol intake and blood glucose as well as mental health factors such as depression,” said lead investigator Ruth Hackett, PhD, of the Institute of Psychiatry, Psychology and Neuroscience at King's College London, in a statement.

With the impact of loneliness on cardiovascular and overall health receiving renewed emphasis during the pandemic, a team of investigators designed the current study to further explore prospectively associated loneliness with incident type 2 diabetes. To do this, investigators chose to perform an analysis of patients from the English Longitudinal Study of Aging (ELSA). For the purpose of their study, Hackett and colleagues examined association between loneliness measured during the second visit of the study and incident type 2 diabetes during the next 5 visits.

From this study, which screened more than 8000 patients, investigators were able to identify a cohort of 4112 participants who were free from diabetes. The mean age of these patients was 65.02±9.05 and the median follow-up period was 12 years. Of note, presence of diabetes was defined as having an HbA1c value of more than 6.5%. Compared to those who were excluded, those included in the analysis ere significantly less lonely, more likely to be younger, wealthier, and of white ethnicity than their counterparts who were included (P <.001).

Upon analysis, 264 of the 4112 diabetes-free participants developed type 2 diabetes over 12 years of follow-up. Results of the analysis indicated loneliness was a significant predictor of incident type 2 diabetes (HR, 1.46; 95% CI, 1.15-1.84; P=.002) in models adjusted for age, sex, ethnicity, wealth, smoking status, physical activity, alcohol consumption, body mass index, HbA1c, hypertension, and cardiovascular disease. Additionally, further analysis indicated an association between loneliness and onset of type 2 diabetes (HR, 1.41; 95% CI, 1.04-1.90; P=.027) in models adjusted for depressive symptoms, living alone, and social isolation.

Investigators also pointed out living alone and social isolation were not significantly associated with onset of type 2 diabetes in their analyses.

“The study also demonstrates a clear distinction between loneliness and social isolation in that isolation or living alone does not predict type 2 diabetes whereas loneliness, which is defined by a person's quality of relationships, does,” Hackett added, in the aforementioned statement.

This study, “Loneliness and type 2 diabetes incidence: findings from the English Longitudinal Study of Ageing,” was published in Diabetologia.