The study was published in the European Heart Journal, a journal of the European Society of Cardiology (ESC). “The quality of social contact appears to be more important than the number of activities for heart disease in people with diabetes,” said study author Tulane University School of Public Health and Tropical Medicine, US, New Orleans, US. “The importance of loneliness on our physical and mental health should not be underestimated. I would encourage people with diabetes who feel lonely to join a group or class and try to make friends with people who share interests.”
“Loneliness and social isolation are common in today’s society and have become a focus of research over the past years, particularly driven by the COVID-19 pandemic and the continued digitalization of society,” noted an accompanying editorial. Loneliness refers to the quality of social contact, while isolation refers to the quantity. They add: “The human species is social by nature. Humans not only desire the presence of others but also depend on meaningful social relationships.[s] Develop into healthy adults. As individuals, we strive to belong to a family, a peer group, a community. This social interaction with family, friends, neighbors or colleagues is paramount to our physical and mental well-being.”
Diabetic patients have a higher risk of cardiovascular disease and are more likely to be lonely than their healthy peers. Previous studies in the general population have shown that both loneliness and social isolation are associated with a higher likelihood of cardiovascular disease. The study examined whether patients with diabetes who were lonely or socially isolated were more likely to develop cardiovascular disease than those who were not.
The study included 18,509 adults aged 37 to 73 with diabetes but no cardiovascular disease at baseline in the UK Biobank. Loneliness and isolation were assessed with questionnaires, with high-risk characteristics assigned one point each.
Characteristics of high-risk loneliness were feeling lonely and never or almost never being able to confide in anyone, for a total of 0 to 2. High-risk social isolation factors were living alone, seeing friends and family less than once a month, and not participating in social activities at least once per week, with a total score of 0 to 3.
The researchers analyzed the association between loneliness, isolation and incident cardiovascular disease after adjusting for factors that may influence the relationship, including sex, age, deprivation, body mass index (BMI), medication, physical activity, diet, alcohol, smoking and controls. Blood sugar, blood pressure and cholesterol. During a mean follow-up of 10.7 years, 3,247 participants developed cardiovascular disease, including 2,771 coronary heart disease and 701 stroke (some patients had both). Compared to participants with the lowest loneliness scores, the risk of cardiovascular disease was 11% and 26% higher with scores of 1 or 2, respectively. Similar results were observed for coronary heart disease but the association with stroke was not significant. Social isolation scores were not significantly associated with cardiovascular outcomes.
The researchers also assessed the relative importance of loneliness compared to other risk factors in the incidence of cardiovascular disease. Loneliness showed weaker effects than kidney function, cholesterol, and BMI, but stronger effects than depression, smoking, physical activity, and diet. Professor Qi said: “Loneliness ranks higher as a predisposing factor for cardiovascular disease than many lifestyle habits. We also found that for people with diabetes, the consequences of physical risk factors (such as poorly controlled blood sugar, high blood pressure, high cholesterol, smoking), and poor kidney function) was higher in those who were lonely than those who were not.” He concluded, “Findings suggest that asking diabetics about loneliness should be part of quality assessments, including referrals to mental health services.”
