Researchers have found that among people with diabetes, loneliness poses a greater risk of heart disease than diet, exercise, smoking and depression. The results of this study were published in the European Heart Journal, a publication of the ESC.
“The quality of social contact appears to be more important for heart health in people with diabetes than the number of engagements,” said study author Professor Lu Qi of Tulane University School of Public Health and Tropical Medicine, New Orleans, USA. “We should not underestimate the importance of loneliness for physical and emotional health. I would encourage people with diabetes who feel lonely to join a group or class and try to make friends with people who share common interests.’
“Loneliness and social isolation are common in today’s societies and have become the focus of research in recent years, especially due to the COVID-19 pandemic and the constant digitization of society,”2 Kahl et al. in the accompanying editorial. Loneliness refers to the quality of social contacts, while isolation refers to the quantity.
They add: “The human species is inherently social. Humans not only require the presence of others, but rely on meaningful social relationships to develop into healthy adulthood. As individuals, we strive to belong to a family, a peer group, a community. These social interactions with family, friends, neighbors or colleagues are paramount to our physical and mental well-being.”
Patients with diabetes are at greater risk of cardiovascular disease and are more likely to be lonely than their healthy peers. Previous studies in the general population have found that loneliness and social isolation are associated with a higher likelihood of cardiovascular disease. This study in patients with diabetes investigated whether patients 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 in the UK Biobank with diabetes but no cardiovascular disease. Loneliness and isolation were assessed using questionnaires, with high-risk items scored one point each. High-risk features of loneliness were feeling lonely and never or almost never being able to confide in someone, with a total score of 0 to 2. High-risk factors for social isolation were living alone, visiting friends and family less than once a month, and not participating in social activities at least once a week with a total score of 0 to 3.
The researchers analyzed the link between loneliness, isolation and cardiovascular disease after adjusting for factors that could influence the relationship, including gender, age, deprivation, body mass index (BMI), medication, physical activity, diet, alcohol, smoking and blood control. 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 for those with scores of 1 or 2. Similar results were seen for coronary heart disease, but the association with stroke was not significant. Social isolation scores were not significantly related to any of the cardiovascular outcomes.
The researchers also assessed the relative importance of loneliness compared to other risk factors for cardiovascular disease. Loneliness had a weaker effect than kidney function, cholesterol and BMI, but a stronger effect than depression, smoking, physical activity and diet.
