Loneliness increases the risk of type 2 diabetes: a 20 year follow-up - results from the HUNT study

Roger E Henriksen; Roy M Nilsen; Ragnhild B Strandberg

doi:10.1007/s00125-022-05791-6

Loneliness increases the risk of type 2 diabetes: a 20 year follow-up - results from the HUNT study

Diabetologia. 2023 Jan;66(1):82-92. doi: 10.1007/s00125-022-05791-6. Epub 2022 Sep 28.

Authors

Roger E Henriksen¹, Roy M Nilsen², Ragnhild B Strandberg²

Affiliations

¹ Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway. reh@hvl.no.
² Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.

Abstract

Aims/hypothesis: Type 2 diabetes is one of the leading causes of death globally and its incidence has increased dramatically over the last two decades. Recent research suggests that loneliness is a possible risk factor for type 2 diabetes. This 20 year follow-up study examined whether loneliness is associated with an increased risk of type 2 diabetes. As both loneliness and type 2 diabetes have been linked to depression and sleep problems, we also investigated whether any association between loneliness and type 2 diabetes is mediated by symptoms of depression and insomnia.

Methods: We used data from the Trøndelag Health Study (HUNT study), a large longitudinal health study based on a population from central Norway (n=24,024). Self-reports of loneliness (HUNT2 survey, 1995-1997) and data on HbA_1c levels (HUNT4 survey, 2017-2019) were analysed to evaluate the associations between loneliness and incidence of type 2 diabetes. Associations were reported as ORs with 95% CIs, adjusted for sex, age and education. We further investigated the role of depression and insomnia as potential mediating factors.

Results: During the 20 year follow-up period, 4.9% of the study participants developed type 2 diabetes. Various degrees of feeling lonely were reported by 12.6% of the participants. Individuals who felt most lonely had a twofold higher risk of developing type 2 diabetes relative to those who did not feel lonely (adjusted OR 2.19 [95% CI 1.16, 4.15]). The effect of loneliness on type 2 diabetes was weakly mediated by one subtype of insomnia but not by symptoms of depression.

Conclusions/interpretation: This study suggests that loneliness may be one factor that increases the risk of type 2 diabetes; however, there is no strong support that the effect of loneliness on type 2 diabetes is mediated by depression or insomnia. We recommend that loneliness should be included in clinical guidelines on consultations and interventions related to type 2 diabetes.

Keywords: Depression; HUNT study; Insomnia; Loneliness; Type 2 diabetes.

MeSH terms

Diabetes Mellitus, Type 2* / epidemiology
Follow-Up Studies
Humans
Loneliness
Norway / epidemiology