A recent study warned that feeling lonely and unhappy ages more than smoking. Now, along the same lines, other research ensures that the feeling of loneliness increases the risk of developing type 2 diabetes, according to a new study published in ‘Diabetologia’, the journal of the European Association for the Study of Diabetes.
The research was carried out by Associate Professor Roger E. Henriksen and colleagues from the Western Norwegian University of Applied Sciences. In addition to examining the association between loneliness and the risk of developing diabetes, he looked at whether depression and insomnia also play a role.
A growing body of research points to a link between psychological stress and a person’s risk of developing type 2 diabetes. Loneliness creates a chronic and sometimes long-lasting state of distress that can activate the body’s physiological stress response. While the exact mechanisms are not fully understood, this response is thought to play a central role in the development of diabetes through mechanisms such as temporary insulin resistance caused by elevated levels of the stress hormone cortisol.
This process also involves changes in the regulation of eating behavior by the brain, which causes a increased appetite for carbohydrates and thus elevated blood sugar levels. Previous studies have found an association between loneliness and unhealthy eating, including increased consumption of sugary drinks and foods high in sugar and fat.
The researchers used data from the HUNT study, a collaboration between the HUNT Research Center (School of Medicine and Health Sciences, Norwegian University of Science and Technology), Trøndelag County Council, Central Norway Regional Health Authority and the Norwegian Institute of Public Health. This database contains health information (from self-reported questionnaires, medical examinations and blood samples) of more than 230,000 people and was obtained through four population surveys: HUNT1 (1984-1986), HUNT2 (1995- 1997), HUNT3 (2006-2008) and HUNT4 (2017-2019).
Of 24,024 people whose data was taken from HUNT2, 1,179 (4.9%) developed type 2 diabetes during the course of the study (1995-2019). These individuals were more likely to be male (59% vs. 44%) and had a higher mean age (48 vs. 43 years) than those without the disease. They were also more likely to be married (73% vs. 68%) and have the lowest level of education (35% vs. 23%). Feelings of loneliness were reported by 13% of the participants.
The study found that higher levels of loneliness Initially, they were strongly associated with a increased risk of type 2 diabetes when measured 20 years later. After adjusting for age, gender and educational level, they found that participants who answered “a lot” when asked if they had felt lonely were twice as likely to develop type 2 diabetes as those who did not feel lonely. Further analysis showed that this relationship was not altered by the presence of depression, sleep onset or end insomnia, although the team did find evidence of a link with sleep maintenance insomnia.
Although their study did not examine the exact mechanisms involved, the researchers note that social support, influence and engagement can have positive effects on health-promoting behaviors. For example, the advice and support of a friend can influence a person’s health choices and have a positive effect on their diet, level of physical activity, and general feelings of stress. Fewer social ties and a lack of these positive influences can make lonely people more vulnerable to behaviors that could increase their risk of developing type 2 diabetes.
The researchers advise that loneliness be included in clinical guidelines related to type 2 diabetes. “It is important for health care providers to be open to dialogue about an individual’s concerns during clinical consultations, including regarding loneliness and social interaction,” they point out.
The authors recommend that more research be done on the mechanisms involved in the link between loneliness and type 2 diabetes, as well as the roles played by insomnia and depression. “The questions that need to be answered are the extent to which loneliness leads to the activation of stress responses, the extent to which loneliness affects health-related behavior, and more importantly, how do these two pathways interact in terms of contributing to an increased risk of type 2 diabetes,” they conclude.