Abstract
BackgroundThe role of an individual’s social network satisfaction (SNS) in the association of social isolation or living alone and incident type 2 diabetes (T2D) is unclear. We assessed the association of SNS with incident T2D and analysed potential modifications of the SNS-T2D association by social isolation or living alone.MethodsThe study population (N = 6839 aged 25–74 years without diabetes at baseline) derived from the prospective population-based MONICA/KORA study (1989–2009). Social network satisfaction was assessed by a single item. Cox regression was used to estimate hazard ratios (HR) for SNS separately in men and women.ResultsIn men with low SNS, risk for incident T2D increased significantly (HR: 2.15, 95% CI: 1.33–3.48, p value 0.002). After additional adjustments for social isolation or living alone, the risk for incident T2D was still significant, albeit less pronounced (HRs 1.85 or 2.05, p values 0.001 or 0.004). The interaction analysis showed an increased T2D risk effect for low SNS compared to high SNS in women living in a partnership (HR: 2.11, 95% CI: 1.00–4.44, p value for interaction: 0.047) and for moderate SNS compared to high SNS in socially connected women (1.56, 1.01–2.39, 0.010).ConclusionsFurther research is needed to address the complexities of the perception of social relationships and social interactions, or interdependence, especially when another major public health issue such as T2D is concerned.
Highlights
The role of an individual’s social network satisfaction (SNS) in the association of social isolation or living alone and incident type 2 diabetes (T2D) is unclear
Low social network satisfaction was more pronounced in men than in women (p < 0.001); in men, unsatisfying SNS was reported by 3.7% and 52.6% compared to proportions of 2.9% and 44.6% in women
When running the model with social isolation or living alone as exposure instead of SNS, we found that the association of social isolation or living alone and incident T2D was only marginally confounded by low SNS: for social isolation, the hazard ratios (HR) were 1.42 in a model without SNS and 1.39 with additional adjustment for SNS
Summary
The role of an individual’s social network satisfaction (SNS) in the association of social isolation or living alone and incident type 2 diabetes (T2D) is unclear. Isolated individuals are at higher risk of increased morbidity and mortality, hospitalisation or poor cognitive function compared to those who are more socially integrated [2, 3]. These findings relate to the effects of objective social network support, and for perceived (subjective) loneliness [1, 4]. There is consensus that women have a greater number of close relationships than men [9, 10].
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