Make a friend, avoid diabetes? It’s not quite that simple, but a new study finds that social interaction with a circle of friends and family has a close and dramatic association with the ability to fend off Type 2 diabetes.
Women in particular appeared to suffer from a lack of a personal network. Socially isolated women were more than twice as likely to have been diagnosed with Type 2 diabetes than women who were socially active, and were 60 percent more likely to develop pre-diabetes. The results among men were also significant but lower: Lack of social connection was associated with 42 percent higher odds of having been diagnosed with Type 2 diabetes.
But the situation was reversed when the researchers looked at living alone, as opposed to having a social circle. There was no difference in diabetes risk for women whether or not they lived with others, but men who lived alone were 59% more likely to develop pre-diabetes, and 94 percent more likely to have previously been diagnosed with Type 2 diabetes.
In ways, the findings, published in December in the journal BMC Public Health, aren’t surprising. Social isolation is known to affect many aspects of our health. Writing in Harvard Business Review last September, former U.S. Surgeon General Vivek H. Murthy called loneliness a “growing health epidemic” implicated in everything from opioid addiction to heart disease.
“Loneliness and weak social connections are associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day and greater than that associated with obesity,” he wrote, and associated with cardiovascular illness and dementia.
Nor is this the first time that loneliness has been connected to diabetes, as the authors of the latest report note. A study in 2007, published in the journal Endocrinology, found that mice who were exposed to chronic social isolation gained body fat and developed diabetes.
And last October, a Korean study found that people who eat alone at least twice a day are more likely to develop metabolic syndrome, a possible sign of pre-diabetes. The study was published in the journal Obesity Research & Clinical Practice.
The newest study, conducted by the Maastricht University Medical Center in the Netherlands, examined the records of close to 3,000 people who were already taking part in the Maastricht Study, a large population research project in the Netherlands that examines various topics around Type 2 diabetes. The researchers asked the subjects, ages 40 to 75, to fill out a questionnaire about their social lives.
The questions delved deeply into the size and nature of the participants’ social connection, asking how many people they interacted with, whether those were friends or family and how close geographically these people lived to them.
From this, they were able to determine that women with 12 or more people among their social connections were more likely to have normal blood glucose levels than women with eight to 11 people in their network. They found, unsurprisingly, that having many of those social connections within walking distance also made a significant difference.
Men appeared to need a slightly smaller circle of people in their lives. Those with 10 or more social connections were more likely to have normal blood glucose levels.
The researchers attempted to control for various factors that could influence the outcome, but because the study looked at correlations rather than causality, the relationship between social connection and diabetes might be more complicated. For example, getting together socially might mean being exercising more, since many social groups involve physical activity. But it could be the other way around: People who are physically active might be more likely seek out others with whom they can exercise, which means the social interaction isn’t what’s making the difference.
Men who live alone might not have higher diabetes risk because they are lonely, but because women often are the ones in a household who prepare healthy meals from scratch.
Still, the results were striking enough to suggest that more social interaction would be a useful strategy in combating diabetes. Perhaps those who aren’t physically active would move around more if they had others to join them. Certainly, loneliness has been strongly connected to depression, and depressed people are less likely to exercise, eat well and keep stress levels under control.
Stephanie Brinkhues, lead author of the study and a doctoral candidate at Maastricht University, wrote a blog post in which she suggested that health care providers should recommend social interaction to their patients.
“Ideally, new lifestyle interventions should be combined with stimulating participants to become member of a club (e.g. volunteer organization, sports club, discussion group),” she wrote, “as we have shown that a lack of participation in social activities was associated with pre-diabetes and previously diagnosed T2DM. Thus, social network size and social participation may be used as a risk indicator in diabetes prevention strategies.”