The emotion that worsens heart trouble in diabetics

Do you ever feel lonely? Of course, we all do on occasion to some degree. But a surprising number of us feel it far too deeply and far too often — to the point that loneliness has become “epidemic.”

The U.S. Surgeon General released a report in May 2023 entitled “Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community.” In it, Surgeon General Dr. Vivek H. Murthy cautions that loneliness could be just as deadly for us as smoking up to 15 cigarettes a day.

According to his report, loneliness is associated with obesity and physical inactivity, as well as a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety and premature death — and there are plenty of published studies that back that up, like this one.

And now, it’s been found that loneliness can be an even bigger risk factor for some of these life-threatening conditions than other commonly recognized health markers — particularly in people with diabetes.

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Diabetes, cardiovascular disease and loneliness

A team of U.S. researchers singled out 18,509 adults aged 37 to 73 years in the U.K. Biobank who had diabetes but no cardiovascular disease at the start of a study in which they planned to track their loneliness scores over a ten-year period, assigning one point to each high-risk feature.

Loneliness measurements included feeling lonely and almost never being able to confide in someone. Social isolation was measured based on whether a participant lived alone, had visits from friends and family less than once a month and no participation in social activities at least once a week.

Over time, 3,247 participants developed cardiovascular disease (either coronary heart disease, stroke or both). Using their scores, the researchers analyzed connections between loneliness, isolation and cardiovascular disease, adjusting for any factors that could influence the relationships—and this is what they found:

• When compared with those with the lowest loneliness score, the risk of cardiovascular disease was 11 percent higher in those with a loneliness score of 1 and 26 percent higher in those with a loneliness score of 2.
• When looking specifically at coronary heart disease, the results were similar to those of cardiovascular disease.
• The association with stroke was not significant.
• There was no significant link between social isolation scores and any of the cardiovascular outcomes.

You might wonder how much loneliness stacked up when compared with other known cardiovascular disease risk factors. It was determined to have a weaker influence than cholesterol, BMI or kidney function, but had a stronger influence than diet, physical activity, depression or smoking.

That last part is compelling to say the least. We’ve been warned of the impact of diet, exercise and giving up smoking for heart health — yet, for diabetics loneliness can hit harder.

And not only that, the consequences of physical risk factors like poorly controlled blood sugar, high blood pressure, high cholesterol, smoking and poor kidney function were greater in those who were lonely than those who were not.

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Being with friends, companions or family matters for health

As study author Lu Qi, a professor at Tulane University School of Public Health and Tropical Medicine shared, “The quality of social contact appears to be more important for heart health in people with diabetes than the number of engagements.”

That means Facebook just won’t cut it.

According to the study authors, human beings are inherently social by nature. “Humans not only require the presence of others but rely on meaningful social relationships to develop into healthy adulthood,” they write in an editorial accompanying the study.

“As individuals, we strive to belong to a family, a peer group, a community,” they add. “These social interactions with family, friends, neighbors or colleagues are paramount for our physical and mental well-being.”

Qi says the findings of the study suggest part of a standard assessment of diabetes should be asking patients if they are lonely and offering referrals to mental health services.

“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,” he adds.

My colleague Joyce Hollman also has some great suggestions for overcoming loneliness. One of my favorites is joining (or starting) a book group. I’ve done this when moving to a new area, and I find it’s a great way to get to know people and form friendships.

Sources:

Loneliness linked with elevated risk of cardiovascular disease in patients with diabetes — EurekAlert!

Joint association of loneliness and traditional risk factor control and incident cardiovascular disease in diabetes patients — European Heart Journal

A lonely heart is a broken heart: it is time for a biopsychosocial cardiovascular disease model — European Heart Journal