For people with diabetes, loneliness is a bigger risk factor for heart disease than diet, exercise, smoking, and depression.

“The quality of social contact appears to be more important for heart health in people with diabetes than the number of engagements,” says study author Lu Qi, professor at Tulane University School of Public Health and Tropical Medicine.

“We should not downplay the importance of loneliness on physical and emotional health. I would encourage patients with diabetes who feel lonely to join a group or class and try to make friends with people who have shared interests.”

Patients with diabetes are at greater risk of cardiovascular disease and are more likely to be lonely than their healthy peers. Previous studies have found that loneliness and social isolation are both related to a higher likelihood of cardiovascular disease in the general population.

The new study, published in the European Heart Journal, looked at whether diabetics who were lonely or socially isolated were more likely to develop cardiovascular disease than those who were not. The study included 18,509 adults aged 37 to 73 years in the UK with diabetes but no cardiovascular disease.

Loneliness and isolation were assessed with questionnaires. High-risk loneliness features were feeling lonely and never or almost never being able to confide in someone. High-risk social isolation factors were living alone, having friends and family visit less than once a month, and not participating in a social activity at least once per week.

The researchers looked at the association between loneliness, isolation, and incidents of cardiovascular disease after adjusting for other health and lifestyle factors.

Read the full article about heart risks for people wit diabetes by Keith Brannon at Futurity.