Abstract

Aims/hypothesisLoneliness is associated with all-cause mortality and coronary heart disease. However, the prospective relationship between loneliness and type 2 diabetes onset is unclear.MethodsWe conducted a longitudinal observational population study with data on 4112 diabetes-free participants (mean age 65.02 ± 9.05) from the English Longitudinal Study of Ageing. Loneliness was assessed in 2004–2005 using the revised University of California, Los Angeles (UCLA) Loneliness Scale. Incident type 2 diabetes cases were assessed from 2006 to 2017. Associations were modelled using Cox proportional hazards regression, adjusting for potential confounders, which included cardiometabolic comorbidities.ResultsA total of 264 (6.42%) participants developed type 2 diabetes over the follow-up period. Loneliness was a significant predictor of incident type 2 diabetes (HR 1.46; 95% CI 1.15, 1.84; p = 0.002) independent of age, sex, ethnicity, wealth, smoking status, physical activity, alcohol consumption, BMI, HbA1c, hypertension and cardiovascular disease. Further analyses detected an association between loneliness and type 2 diabetes onset (HR 1.41; 95% CI 1.04, 1.90; p = 0.027), independent of depressive symptoms, living alone and social isolation. Living alone and social isolation were not significantly associated with type 2 diabetes onset.Conclusions/interpretationLoneliness is a risk factor for type 2 diabetes. The mechanisms underlying this relationship remain to be elucidated.Graphical abstract

Highlights

  • Loneliness is a negative emotion that occurs when an individual perceives that their social needs are not being met

  • Meta-analytic evidence suggests that loneliness is a predictor of all-cause mortality, indicating that lonely individuals have a 22% greater risk of death when compared with non-lonely individuals [4]

  • We investigated the association between loneliness measured at wave 2 (2004–2005; the first wave in which loneliness was assessed) and incident type 2 diabetes from wave 3 (2006–2007) to wave 8 (2016–2017)

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Summary

Introduction

Loneliness is a negative emotion that occurs when an individual perceives that their social needs are not being met. It reflects an imbalance between desired and actual social relationships [1]. Loneliness has a negative effect on cardiovascular health and has been associated with incident CHD [5]. This is of relevance in type 2 diabetes, as CHD is a frequent complication of the condition and a leading cause of death in this population [6]

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