Diabetes
The association between loneliness and the risk of diabetes mellites in Japanese middle-aged and older adults: a population-based prospective cohort study Yuki Arakawa* Yuki Arakawa Atsushi Goto Miho Hara Kosuke Inoue Izumi Nakayama Kozo Tanno Nobuyuki Takanashi Kazumasa Yamagishi Isao Muraki Nobufumi Yasuda Isao Saito Tadahiro Kato Kazuhiko Arima Ayuko Takatani Hikaru Ihira Rieko Kanehara Taiki Yamaji Motoki Iwasaki Manami Inoue Shoichiro Tsugane Norie Sawada
Background: Diabetes prevention is an important public health issue, and discovering its social determinants of diabetes is crucial. Though several studies have explored the association between loneliness and diabetes risk, large population-based cohort studies linked with outpatient clinical data remain scarce.
Methods: From 114,054 Japanese aged 40-75 years old recruited between 2009 and 2017 in the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT), 61,356 individuals who had registered claim data without self-reported diabetes at study participation were analyzed. We used loneliness as an exposure variable assessed by a direct question asking about feelings of loneliness in a baseline questionnaire. Diabetes occurrence was derived from the claim data defined by a validated algorithm using ICD-10 codes starting from “E11-14” and diabetes drug prescriptions. The follow-up duration was until the end of available claim data or 2022 March. We evaluated the association between loneliness and diabetes risk using a Cox proportional hazard model with covariates adjustment. Subgroup analyses by sociodemographic characteristics were also conducted.
Findings: The mean age was 61.1 (SD: 8.8) and females were 54.6%, of whom 2471 (4%) reported high loneliness. Participants with high loneliness tended to live alone, be unmarried, have a depression history, and not be engaged in social participation. During a mean follow-up time of 7.2 years, 3958 new cases of diabetes were identified. Compared to the participants with low loneliness, those with high loneliness had a higher risk of diabetes (HR: 1.21 [95%CI: 1.03, 1.41]). The association was largely consistent across sociodemographic characteristics (p-values for heterogeneity > 0.10).
Conclusions: We identified an association between loneliness and an increased risk of diabetes among Japanese adults, underscoring the importance of recognizing loneliness as a risk factor for diabetes.