Social isolation, loneliness increase susceptibility to diabetic microvascular complications

Individuals with type 2 diabetes mellitus (T2DM) who experience social isolation and loneliness may be at increased risk of diabetic microvascular complications (DMCs), as suggested in a study.

The study included 24,297 UK Biobank participants (mean age 60.0 years, 62.2 percent male) with T2DM and no DMC at baseline. Of these participants, 10,212 (42.0 percent) reported experiencing moderate isolation, 4,754 (19.6 percent) most isolation, and 1,898 (7.8 percent) loneliness.

Over a median follow-up of 12.6 years, DMC occurred in 5,530 patients, including 3,458 with diabetic kidney disease, 2,255 with diabetic retinopathy, and 1,146 with diabetic neuropathy.

Multivariable cause-specific hazards regression analysis showed that the highest level of social isolation was associated with a heightened risk of any DMC component (most vs least: hazard ratio [HR], 1.13, 95 percent confidence interval [CI], 1.05–1.22), particularly diabetic kidney disease (HR, 1.14, 95 percent CI, 1.04–1.25) and neuropathy (HR, 1.31, 95 percent CI, 1.11–1.53).

There was also evidence of association seen between any level of loneliness and elevated risk of any DMC component (HR, 1.12, 95 percent CI, 1.02–1.23), especially diabetic kidney disease (HR, 1.16, 95 percent CI, 1.03–1.30).

The magnitude of association of DMC risk with social isolation and loneliness and was comparable to that observed with other conventional risk factors including smoking, blood pressure, and physical activity.

The present data highlight social isolation and loneliness as novel and potentially modifiable risk factors for DMC.