Loneliness and social isolation are likely to increase the risk of diabetes, researchers have found. A new study published in the British Medical Journal in early February explored the associations of marital status with average blood sugar levels in adults over 50 years of age. The study found that those in marital or cohabiting relationships, regardless of the quality of the relationship, are associated with lower blood glycemic levels compared to those who live on their own or are feeling lonely.
Diabetes is one of the biggest health problems that India grapples with today. “India is often referred to as the diabetic capital of the world,” says Dr Sunil Kumar Mishra, senior director for the division of endocrinology and diabetes, endocrinology and diabetology at the Medanta Hospital in Gurugram. The prevalence of Type 2 diabetes has rapidly increased in the country in the last few decades and doctors are now receiving Type 2 diabetes complaints from people as young as 30 to 40 years, Mishra adds.
Additionally, stress, loneliness, and anxiety increase the risk of metabolic disorders among Type 2 diabetes patients, explains Mishra, adding that people who are suffering often stay alone. This impacts their overall health; their physical activity goes down, they become obese, and their calorie intake goes up. “As a result of excessive stress and unhealthy eating habits, a counter-regulatory hormone called cortisol is secreted. Elevated cortisol levels over the long term consistently produce glucose, leading to increased blood sugar levels. Therefore, people who are under stress and are living in isolation are at greater risk of developing diabetes in the future,” says Mishra.
Dr Anoop Misra, the chairman of Fortis CDOC Hospital for Diabetes and Allied Sciences in Delhi, further explains that loneliness leads to noncompliance to diet and exercise, as well as stress — all factors that lead to diabetes. “In addition, support required during stressful periods is missing, which creates more problems. It may also lead to smoking and alcohol abuse,” he warns.
An earlier study from the year 2014 found that loneliness influences the level of consumption of sugary beverages, which adds to the risk of diabetes. Living with someone, whether a spouse, partner or friend, and having a sense of togetherness at work led to a lower intake of sugary beverages. The researchers concluded that perceived loneliness was associated with increased intake of sugary beverages, which further explains why people living alone or in isolation without a partner, family or friends are at a greater risk of developing Type 2 diabetes.
The good news is that Type 2 diabetes can be effectively managed. “First and foremost, a correct diet and regular exercise are needed. Drugs are needed in most patients. Discipline, compliance to drugs and physicians’ check-up help in most cases,” says Misra.
The most common factors that have resulted in the sudden spike of Type 2 diabetes in India in the last two decades include unhealthy lifestyles and practices, such as a lack of physical exercise, smoking and excessive alcohol consumption, argues Mishra. “Furthermore, Type 2 diabetes in young adults has been linked to long-term complications. Diabetes that develops at a young age has a more aggressive course that lasts longer than diabetes that develops later in life, which further adds to the burden,” he says.
In his view, the most effective way of both preventing and managing Type 2 diabetes is to recognise the factors that lead to diabetes and work towards improving them. The risk factors are divided into two categories — modifiable risk factors and non-modifiable risk factors. “A person's family history and age are non-modifiable risk factors. Modifiable risk factors include those that can be changed or improved, e.g., such as being obese or overweight can be managed with the help of a healthy lifestyle and physical activity, including maintaining ideal body weight, eating healthy, managing blood pressure, and avoiding unhealthy practices such as smoking and alcohol consumption. In addition, regular screening, adherence to the treatment protocol, and regular check-ups also are contributing preventive measures to reduce the impact of diabetes. The modifiable risk factors, once corrected, can help control glucose levels and avoid severe Type 2 diabetes,” says Mishra of Medanta.
Shrenik Avlani is a writer and editor and the co-author of The Shivfit Way, a book on functional fitness