How Loneliness can Affect Your Heart If You Have Diabetes

A recent study shows that loneliness is linked to an increase in cardiovascular disease in diabetics.

Highlights:

For diabetics, loneliness is a more crucial risk factor than diet, smoking, or exercise in developing heart disease
Researchers say that the effect of loneliness on diabetics should not be downplayed
Authors urge that a standard assessment of loneliness should be done in people with diabetes to prevent heart disease

Loneliness is a greater risk factor for heart disease in diabetic people than in diet, exercise, smoking, or depression. This is in accordance with a study published in the European Heart Journal ().

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‘People with diabetes who suffer from loneliness have an elevated risk of heart disease. #diabetes #lonely’

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"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.

"We should not downplay the importance of loneliness on physical and emotional health. I would encourage patients with diabetes who feel lonely to join a group or class and try to make friends with people who have shared interests."

"Loneliness and social isolation are common in today's societies and have become a research focus during the last years, especially driven by the COVID-19 pandemic and the continuous digitalization of society," state Kahl and colleagues in an accompanying editorial. Loneliness refers to the quality of social contacts, while isolation refers to the quantity ().

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They add, "The human species is inherently social by nature. Humans not only require the presence of others but also rely on meaningful social relationship[s] to develop into healthy adulthood. As individuals, we strive to belong to a family, a peer group, or a community. These social interactions with family, friends, neighbors, or colleagues are paramount for our physical and mental well-being."

Diabetes patients are at a higher risk of cardiovascular disease and are more likely to be lonely than their healthy counterparts (). Previous research in the general population has indicated that loneliness and social isolation are both associated with an increased risk of cardiovascular disease ().

This research looked at whether diabetics who were lonely or socially isolated were more likely to develop cardiovascular disease than those who weren't.

The study recruited 18,509 adults in the UK Biobank aged 37 to 73 with diabetes but no cardiovascular disease at the start. Loneliness and isolation were assessed via questionnaires, with high-risk characteristics receiving one point each.

Feeling lonely and never or almost never being able to confide in someone were high-risk loneliness features, with a total score of 0 to 2.

Living alone, having friends and relatives visit less than once a month, and not participating in a social activity at least once a week were high-risk social isolation variables, with a total score of 0 to 3.

Participants with loneliness scores of 0, 1, or 2 were 61.1%, 29.6%, and 9.3%, respectively, while 44.9%, 41.9%, and 13.2% had isolation levels of 0, 1, or >2.

The researchers examined the relationship between loneliness, isolation, and incident cardiovascular disease after controlling for factors such as gender, age, deprivation, body mass index (BMI), medications, physical activity, diet, alcohol, smoking, blood sugar, blood pressure, and cholesterol control.

During an average of 10.7 years of follow-up, 3,247 participants acquired cardiovascular illness, with 2,771 suffering from coronary heart disease and 701 suffering from stroke (some patients had both).

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Loneliness Increases the Risk of Cardiovascular Disease

The risk of cardiovascular disease was 11% and 26% higher in individuals with loneliness ratings of 1 and 2, respectively, when compared to those with the lowest loneliness score.

Similar findings were seen for coronary heart disease, although the link with stroke was not statistically significant. Social isolation did not appear to be associated with any of the cardiovascular outcomes.

The researchers also analyzed the relative relevance of loneliness on the incidence of cardiovascular disease in comparison to other risk variables. Loneliness had a stronger impact than depression, smoking, physical activity, and diet, but a smaller influence than kidney function, cholesterol, and BMI.

Professor Qi said, "Loneliness ranked higher as a predisposing factor for cardiovascular disease than several lifestyle habits. We also found that for patients with diabetes, the consequence of physical risk factors (i.e. poorly controlled blood sugar, high blood pressure, high cholesterol, smoking, and poor kidney function) was greater in those who were lonely compared to those who were not."

He concluded, "The findings suggest that asking patients with diabetes about loneliness should become part of standard assessment, with the referral of those affected to mental health services."

References:

Joint association of loneliness and traditional risk factor control and incident cardiovascular disease in diabetes patients - (https://pubmed.ncbi.nlm.nih.gov/37385629/)
A lonely heart is a broken heart: it is time for a biopsychosocial cardiovascular disease model - (https://pubmed.ncbi.nlm.nih.gov/37385630/)
Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1·9 million people - (https://pubmed.ncbi.nlm.nih.gov/25466521/)
Loneliness, Social Isolation, and Chronic Disease Outcomes - (https://pubmed.ncbi.nlm.nih.gov/32865550/)

Source-Medindia

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