Background: The role of an individual's social network satisfaction (SNS) in the association of social isolation or living alone and incident type 2 diabetes (T2D) is unclear. We assessed the association of SNS with incident T2D and analysed potential modifications of the SNS-T2D association by social isolation or living alone.
Methods: The study population (N = 6839 aged 25-74 years without diabetes at baseline) derived from the prospective population-based MONICA/KORA study (1989-2009). Social network satisfaction was assessed by a single item. Cox regression was used to estimate hazard ratios (HR) for SNS separately in men and women.
Results: In men with low SNS, risk for incident T2D increased significantly (HR: 2.15, 95% CI: 1.33-3.48, p value 0.002). After additional adjustments for social isolation or living alone, the risk for incident T2D was still significant, albeit less pronounced (HRs 1.85 or 2.05, p values 0.001 or 0.004). The interaction analysis showed an increased T2D risk effect for low SNS compared to high SNS in women living in a partnership (HR: 2.11, 95% CI: 1.00-4.44, p value for interaction: 0.047) and for moderate SNS compared to high SNS in socially connected women (1.56, 1.01-2.39, 0.010).
Conclusions: Further research is needed to address the complexities of the perception of social relationships and social interactions, or interdependence, especially when another major public health issue such as T2D is concerned.
Keywords: Incident type 2 diabetes; Loneliness; Sex differences; Social isolation; Social network satisfaction.