Department of Endocrinology, The Sixth Affiliated Hospital ，School of Medicine， South China University of Technology, Foshan City, Guangdong, China.
Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
BMJ Open. 2024 Mar 19;14(3):e076106. doi: 10.1136/bmjopen-2023-076106.
Social isolation may affect diabetes self-management. This study aimed to explore the relations between social isolation and glycaemic control in patients with diabetes and to explore lifestyle differences among individuals with different levels of social isolation.
The relevant data of 665 people previously diagnosed with diabetes included in the China Health and Retirement Longitudinal Study from 2011 to 2015 were extracted and analysed. The study included patient general information, blood glucose, lipids, glycosylated haemoglobin, social isolation index, health-related lifestyle factors and diabetes-related factors. Differences in metabolic abnormalities and modifiable lifestyles were compared among patients with varying levels of social isolation.
Multiple linear regression analysis demonstrated that among men aged 45-64 years, the high social isolation group had significantly higher glycosylated haemoglobin levels compared with the low isolation group (7.29±1.81 vs 6.59±1.63, p=0.026). A positive correlation was observed between social isolation and blood glucose (β=14.16; 95% CI 2.75 to 25.57; p=0.015) and glycosylated haemoglobin (β=0.35; 95% CI 0.10 to 0.60; p=0.006), indicating that higher social isolation was associated with higher fasting blood glucose and glycosylated haemoglobin levels. However, no significant associations were observed in other age groups. Notably, men aged 45-65 years with high social isolation had higher depression rates (44.10% vs 24.60%, p=0.024), lower engagement in moderate exercise (5.70% vs 23.50%, p=0.019) and shorter 10-minute walks (17.10% vs 36.80%, p=0.027). Differences in other health-related and diabetes-related factors were not statistically significant.
Middle-aged men with diabetes with higher social isolation tend to have higher blood glucose and glycosylated haemoglobin levels. This subset of patients requires targeted attention to provide social support from family and friends for improved glycaemic control. If necessary, education on diabetes should be made available to family members and friends.
社会隔离可能会影响糖尿病患者的自我管理。本研究旨在探讨社会隔离与糖尿病患者血糖控制之间的关系，并探讨不同社会隔离水平个体之间的生活方式差异。
从 2011 年至 2015 年期间中国健康与养老追踪调查中提取并分析了 665 名先前被诊断患有糖尿病的患者的相关数据。该研究包括患者的一般信息、血糖、血脂、糖化血红蛋白、社会隔离指数、与健康相关的生活方式因素和糖尿病相关因素。比较了不同社会隔离水平患者的代谢异常和可改变的生活方式差异。
多元线性回归分析显示，在 45-64 岁的男性中，高社会隔离组的糖化血红蛋白水平明显高于低隔离组（7.29±1.81 与 6.59±1.63，p=0.026）。社会隔离与血糖（β=14.16；95%置信区间 2.75 至 25.57；p=0.015）和糖化血红蛋白（β=0.35；95%置信区间 0.10 至 0.60；p=0.006）呈正相关，表明较高的社会隔离与空腹血糖和糖化血红蛋白水平升高有关。然而，在其他年龄组中未观察到显著关联。值得注意的是，45-65 岁的男性中，高社会隔离组的抑郁发生率更高（44.10%比 24.60%，p=0.024），中度运动参与率更低（5.70%比 23.50%，p=0.019），10 分钟步行距离更短（17.10%比 36.80%，p=0.027）。其他与健康相关和糖尿病相关的因素差异无统计学意义。
中年男性糖尿病患者社会隔离程度越高，血糖和糖化血红蛋白水平越高。这部分患者需要家庭和朋友提供有针对性的社会支持，以改善血糖控制。如有必要，应向家庭成员和朋友提供糖尿病教育。
