Loneliness and Social Stress Linked to Diabetes Risk in Young Adults

Credit: Adobe Stock/zigres

The researchers found that young adults (ages 18 – 35) who experienced more loneliness, stress and discrimination had higher chances of developing type 2 diabetes (T2D) or prediabetes. In contrast, those with stronger social support and a sense of belonging in their neighborhood were less likely to have these conditions. Results lead investigators to believe addressing social experiences could be a way to reduce the risk of diabetes in young adults.

The prevalence of T2D in young adults and adolescents is predicted to increase by almost 700% by 2060. The condition is linked to a variety of severe outcomes, such as an 80% cumulative incidence of microvascular complications within the first 15 years of diagnosis, which can contribute to a significant reduction in life expectancy.

“Although early glycemic control may improve outcomes, for adults younger than 35 years, current guidelines recommend no routine screening for T2D, or screening in the setting of risk factors such as overweight or obesity, first-degree relative with diabetes, metabolic complications, and higher-risk race and ethnicity,” wrote a team of investigators led by Caleb Harrison, BS, associated with the Center for Pediatric Research in Obesity and Metabolism at the University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh. “However, additional risk factors may be important to consider, including social determinants of health (SDOH) such as loneliness, social support, and discrimination, each of which is associated with incidence of T2D in older adults.”

To determine the link between T2D or prediabetes and loneliness and other social experiences in young adults, investigators conducted a cross-sectional analysis using data, collected between 2018 and 2022, from the All of Us Research Program. Exposures, measured by standardized surveys, included social support, neighborhood social cohesion, discrimination, loneliness and stress. The primary outcome was T2D or prediabetes by health records or self-reported data. The analysis adjusted for age, race or ethnicity, sex, income and family history.

Data from 14,217 young adults were collected. Participants had an average age of 28.2 years, most (70.3%) were women and 64.1% were White. Among the cohort, 5.5% had either prediabetes or T2D.

The analysis showed young adults who experienced higher levels of loneliness, stress, discrimination, low social support and low sense of belonging in their neighborhood had an increased risk of developing prediabetes or T2D. Those who felt the most lonely had a 42-75% higher chance of having diabetes compared to those who were the least lonely. Additionally, people with the least social support or who lived in less socially connected neighborhoods also had a higher likelihood of diabetes. Higher stress and experiences of discrimination, both in daily life and healthcare settings, were also linked to a greater risk of prediabetes or T2D. Results underscore the strong influence of social and emotional factors on diabetes risk.

Investigators said the cross-sectional nature limited the findings, as they were unable to determine causality. However, they assume the relationship between social risk and prediabetes is bidirectional—young people with chronic disease may also experience issues with social relationships and peer support. Additionally, generalizability may be hindered as most of the cohort were White individuals, despite All of Us focusing on enrolling individuals from historically underrepresented populations.

“These findings may inform novel strategies to modify diabetes screening, moving toward more actionable, potentially modifiable characteristics,” investigators concluded. “If successfully implemented, approaches that screen for and address adverse social risk factors such as loneliness, lack of social support and discrimination may ultimately reduce the risks associated with young-onset T2D via prevention as well as early identification and treatment.”