February 22, 2017
2 min read

Worsening quality of life, social isolation associated with recent type 2 diabetes diagnosis

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In the first 5 years after a type 2 diabetes diagnosis, adults are five times more likely than those without the disease to report a worsening quality of life and a reduction in social contacts, whereas the odds of experiencing psychological distress were only modestly associated with disease diagnosis, according to a recent longitudinal analysis from Australia.

“Circumstances such as whether a person feels they can draw on the support of a social network … do play an important role in mental health trajectories as well as all other aspects of life,” wrote Xiaoqi Feng, PhD, and Thomas Astell-Burt, PhD, of the Population Wellbeing and Environment Research Lab, School of Health and Society, University of Wollongong in New South Wales, Australia. “These are circumstances that also likely play a role in shaping whether people are able to adhere to lifestyle modification programs, pharmacotherapy regimens, and the regular visits to general practitioners that are a staple of [type 2 diabetes] management. Therefore, declining quality of life and increasing social isolation among people who are recently diagnosed with [type 2 diabetes] are scenarios that ought to be monitored closely by general practitioners and the local health sector if devastating and hugely expensive, but preventable comorbidities and complications are to be successfully avoided.”

Feng and Astell-Burt analyzed longitudinal data from 26,344 adults without diabetes at baseline participating in the 45 and Up Study, the largest ongoing study of healthy aging in Australia. Participants, recruited from the Medicare Australia database, completed baseline surveys between 2006 and 2009; follow-up (self-completed survey) was conducted between 2010 and 2011 as part of the Social Economic and Environmental Factors study. Key exposure variable was a diagnosis of type 2 diabetes. Researchers examined six outcome variables: psychological distress (via the Kessler Psychological Distress Scale); self-reported quality of life; and four types of social contact, including spending time with family or friends, talking to friends or family on the phone, attending meetings, social clubs or religious groups, and how many people participants felt they could rely on.

During follow-up, researchers observed 586 new diagnoses of type 2 diabetes. In models adjusted for age, a type 2 diabetes diagnosis was associated with a fivefold increase in the odds of a participant reporting a quality of life rated as “poor” (OR = 5.54; 95% CI, 1.28-24.1). Diagnosis of the diseases was also associated with a reduction in social contacts across all four types.

Researchers also observed a modest increase in the odds of experiencing psychological distress with diagnosis (OR = 1.31; 95% CI, 0.76-2.25); results persisted after adjustment for age, household income, economic status and marital status.

The researchers noted that the research was limited by the length of follow-up time, and that future studies should assess data in both the short term and long term after a type 2 diabetes diagnosis.

“In the best-case scenario, it may be that after the initial shock that many people will experience on being diagnosed with [type 2 diabetes] and [the] subsequent life changes and management strategies that they often must (or ought to) implement, these changes may become less burdensome over time as people gradually adapt to new routines,” the researchers wrote. “This is described as a best-case scenario since, for this to occur, it is likely that people will need support structures around them — socially and financially — but as this study has reported, social contacts tended to reduce across the board following a [type 2 diabetes] diagnosis.” by Regina Schaffer

Disclosure: The National Health and Medical Research Council and the National Heart Foundation of Australia supported this study. The researchers report no relevant financial disclosures.