With a little help from my friends – Getting people out of social isolation could help prevent type 2 diabetes

Social interactions play an important role in human society, and they also play an important role in health. A study published today in BMC Public Health has shown that social isolation is associated with type 2 diabetes. In this blog, Stephanie Brinkhues, lead author of the study, explores the main findings of this study.

Social isolation isn’t just loneliness — it may also affect your health. For instance, social relationships may have an impact on the development of chronic diseases, like type 2 diabetes. A clear picture on how social network characteristics may influence type 2 diabetes could contribute to the prevention of type 2 diabetes, as well as to the improvement of interventions for people who already have the disease.

In our study, we addressed whether social network size, contact frequency, type of relationship (family, friends, acquaintances), living alone and social participation, were associated with several stages of type 2 diabetes: pre-diabetes, newly diagnosed and previously diagnosed type 2 diabetes. In addition, we investigated whether more quality related characteristics of the social network, like emotional or practical support, were associated with pre-diabetes, newly diagnosed, and previously diagnosed type 2 diabetes.

In diabetes women, network members lived closer and were more often family than friends.

To answer these questions, we asked nearly 3000 participants of The Maastricht Study to fill out a questionnaire on their social networks. For example, we asked them to indicate whom they turned to with problems or whom they go out with. Participants in The Maastricht Study are men and women, aged 40 to 75 years, and live in the southern part of the Netherlands.

The network size in individuals with type 2 diabetes appeared to be smaller, women with type 2 diabetes typically had 8 network members compared to 12 in those without diabetes, in men this was 7 in type 2 diabetes compared to 10 in those without diabetes. These results indicate that socially isolated individuals more often have type 2 diabetes. In diabetes women, network members lived closer and were more often family than friends. Apparently, a more centralized social network is associated with type 2 diabetes in women.

Targeting social networks

With these results in mind, we believe that targeting the social network may prove a promising prevention strategy for type 2 diabetes. Socially isolated individuals could be encouraged to improve their lifestyle, for instance lose weight and become more physically active, in a setting that increases their social integration. Such interventions should enable extension and broadening of the social network, by supporting them to make new friends.

Men and women who perceived less social support, and were less involved in social activities, more often had type 2 diabetes.

Moreover, men and women who perceived less social support, and were less involved in social activities, more often had type 2 diabetes. In particular, as men living alone seem to be at a higher risk for the development of type 2 diabetes, they should become recognized as high-risk group in health care.

Ideally, new lifestyle interventions should be combined with stimulating participants to become member of a club (e.g. volunteer organization, sports club, discussion group), 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.

With our study, we endeavor that negative health effects of social isolation and poor social networks become widely recognized. Notably, targeting social network characteristics may also have benefits for other public health concepts, as it has been shown that social networks were also strong predictors for infectious diseases.

Although the mechanisms underlying the associations of social network characteristics with the development of type 2 diabetes are not yet elucidated, our findings are of great importance to the field of diabetes prevention. Our results implicate that strengthening of the social network can be used to optimize non-medical prevention strategies for type 2 diabetes. Our findings support the idea that solving social isolation may prevent the development of type 2 diabetes.

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