Background
Methods
Study population
Measurements
Glucose metabolism status
Social network questionnaire
Structural characteristics of the social network
Variable name | Definition | Unit of measurement (possible range) |
---|---|---|
Structural characteristics of the social network | ||
Network size | The total number of unique network members mentioned in the questionnaire. Participants with a smaller social network size were considered as more socially isolated. | N (0–40) |
Contact frequency
| ||
Total contacts per half year | A contact was defined as an interaction between persons. Total contacts (interactions between persons) per half year were computed as follows. We used the highest contact frequency (e.g., daily contact) for every network member as an indicator of the actual contact frequency. Second, we recoded the answer categories of the questionnaire to an estimated number of contacts per half year. For example, “half-yearly” was assumed to comprise one contact, “quarterly” two contacts, “monthly” 6 contacts and “daily or weekly” 48 contacts. Third, we computed the sum of all contacts per half year as the total contact frequency. | N (0–1920) |
Percentage of daily-weekly contact | We calculated the percentage of network members that the participant had daily or weekly contact with as the number of daily/weekly contacts divided by network size. | % (0–100) |
Proximity
| ||
Percentage of network members living within walking distance | We considered geographic proximity as the percentage of all network members who lived within walking distance, calculated as the number of network members living within walking distance divided by network size. | % (0–100) |
Type of relationship
| ||
Percentage household members | We calculated the percentage of household members as the number of network members living in the same household divided by network size. | % (0–100) |
Percentage family members | We calculated the percentage of family members within the network as the number of family members divided by the network size. | % (0–100) |
Percentage friends | We calculated the percentage of friends within the network as the number of friends divided by the network size. | % (0–100) |
Living alone | Living alone was defined as a person who lived alone in his/ her household. | (yes/no) |
Social participation | Social participation was defined as membership in, for instance, a sports club, religious group, volunteer organization, discussion group, self-support group, internet club, or other organization. | (yes/no) |
Functional characteristics of the social network | ||
Informational support | Informational support was defined as the number of network members that give advice on problems | N (0–5) |
Emotional support (discomfort) | Emotional support related to discomfort was defined as the number of network members that provide emotional support when participants were feeling unwell | N (0–5) |
Emotional support (important decisions) | Emotional support related to important decisions was defined as the number of network members that provide the opportunity to discuss important matters | N (0–5) |
Practical support (jobs) | Practical support related to jobs was defined as the number of network members that help with small and larger jobs around the house | N (0–5) |
Practical support (sickness) | Practical support related to sickness was defined as the number of network members that provide practical help when participants were sick | N (0–5) |
Functional characteristics of the social network (social support)
General measurements
Statistical analysis
Results
NGM (n = 1623) | Pre-diabetes (n = 430) | Newly diagnosed T2DM (n = 111) | Previously diagnosed T2DM (n = 697) |
P-value1
| |
---|---|---|---|---|---|
General measurements | |||||
Age | 58.1 ± 8.1 | 61.6 ± 7.5 | 62.9 ± 7.5 | 62.7 ± 7.7 | <0.001 |
Male sex (%) | 42.2 | 53.3 | 63.1 | 69.4 | <0.001 |
Body mass index (kg/m2) | 25.5 ± 3.6 | 27.7 ± 4.3 | 28.8 ± 4.8 | 29.9 ± 5.0 | |
Educational level (%) | |||||
- low2
| 26.1 | 34.7 | 34.2 | 47.1 | <0.001 |
- intermediate3
| 27.5 | 28.1 | 30.6 | 27.7 | |
- high4
| 45.7 | 36.3 | 34.2 | 24.5 | |
Employment status (%) | |||||
- employed | 46.8 | 35.3 | 28.8 | 27.8 | <0.001 |
- retired | 26.6 | 36.0 | 45.0 | 37.0 | |
- no paid job | 19.6 | 19.8 | 19.8 | 20.1 | |
- not known | 7.1 | 8.8 | 6.3 | 15.1 | |
Smoking status (%) | |||||
- never | 39.6 | 29.8 | 33.3 | 27.7 | <0.001 |
- former | 48.4 | 57.0 | 57.7 | 55.8 | |
- current | 11.9 | 13.3 | 8.1 | 16.1 | |
Alcohol consumption, glasses per week | 7.3 ± 7.1 | 9.1 ± 10.6 | 9.3 ± 10.6 | 6.1 ± 8.5 | <0.001 |
Prior CVD (%) | 11.6 | 12.1 | 20.7 | 27.5 | <0.001 |
Hypertension (%) | 41.2 | 63.6 | 75.7 | 83.9 | <0.001 |
Diabetes medication use (%) | n/a | n/a | n/a | 90.9 | n/a |
Diabetes duration (years; median, Q1-Q3; n = 567) | n/a | n/a | n/a | 7.0 (3.0–12.0) | n/a |
Structural characteristics of the social network | |||||
Network size | 11.00 ± 5.15 | 10.02 ± 5.08 | 7.68 ± 4.59 | 7.61 ± 4.38 | <0.001 |
Contact frequency
| |||||
Total contacts per half year | 249.33 ± 144.09 | 233.13 ± 145.26 | 193.14 ± 123.39 | 196.55 ± 125.58 | <0.001 |
Percentage of daily-weekly contact | 46.29 ± 24.41 | 47.15 ± 25.09 | 53.67 ± 28.04 | 54.16 ± 28.01 | <0.001 |
Proximity
| |||||
Percentage of network members living within walking distance | 28.96 ± 21.28 | 30.79 ± 23.60 | 27.51 ± 24.07 | 27.67 ± 24.20 | 0.158 |
Type of relationship
| |||||
Percentage household members | 14.00 ± 12.48 | 14.42 ± 13.84 | 21.19 ± 20.71 | 17.53 ± 17.41 | <0.001 |
Percentage family members | 55.94 ± 22.34 | 58.30 ± 23.68 | 61.78 ± 27.22 | 64.68 ± 26.00 | <0.001 |
Percentage friends | 30.05 ± 20.30 | 27.23 ± 20.95 | 22.76 ± 21.06 | 21.43 ± 21.96 | <0.001 |
Living alone (%) | 14.7 | 17.4 | 17.1 | 20.2 | <0.05 |
Social participation (%) | 71.6 | 64.2 | 61.1 | 56.4 | <0.001 |
Functional characteristics of the social network | |||||
Informational supporta
| 3.5 ± 1.6 | 3.2 ± 1.7 | 2.7 ± 1.7 | 2.7 ± 1.7 | <0.001 |
Emotional support (discomfort) a
| 3.0 ± 1.6 | 2.6 ± 1.6 | 2.1 ± 1.5 | 2.2 ± 1.5 | <0.001 |
Emotional support (important decisions) a
| 3.4 ± 1.5 | 2.9 ± 1.6 | 2.5 ± 1.7 | 2.4 ± 1.5 | <0.001 |
Practical support (jobs)a
| 3.0 ± 1.5 | 2.7 ± 1.5 | 2.3 ± 1.4 | 2.4 ± 1.4 | <0.001 |
Practical support (sickness) a
| 2.5 ± 1.4 | 2.2 ± 1.4 | 1.8 ± 1.3 | 1.9 ± 1.3 | <0.001 |
Description of structural characteristics of the social network
Description of functional characteristics of the social network
Association of structural characteristics of the social network with diabetes status
Outcome variables stratified by sex
| ||||||
---|---|---|---|---|---|---|
Women | Men | |||||
Reference category; NGM | Pre-diabetes (n = 201) | Newly diagnosed T2DM (n = 41) | Previously diagnosed T2DM (n = 213) | Pre-diabetes (n = 229) | Newly diagnosed T2DM (n = 70) | Previously diagnosed T2DM (n = 484) |
OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |
Explanatory variables
| ||||||
Structural characteristics of the social network | ||||||
Smaller network size (for every fewer network member) | 1.02 (0.99–1.06) | 1.12** (1.03–1.22) | 1.08*** (1.04–1.13) | 0.99 (0.95–1.02) | 1.10** `(1.03–1.18) | 1.05** (1.02–1.09) |
Contact frequency
| ||||||
Total contacts per half year (for every 10 additional contacts) | 1.00 (0.99–1.01) | 0.98 (0.96–1.01) | 0.98* (0.97–1.00) | 1.00 (0.99–1.01) | 0.98# (0.96–1.00) | 0.99(0.98–1.02) |
Percentage of daily-weekly contact (for every additional 10%) | 0.99 (0.92–1.05) | 1.10 (0.97–1.26) | 1.07# (0.99–1.15) | 0.99 (0.93–1.05) | 1.08# (0.98–1.19) | 1.04(0.98–1.09) |
Proximity
| ||||||
Percentage of network members living within walking distance (for every fewer 10%) | 1.03 (0.95–1.11) | 1.21* (1.02–1.42) | 1.09* (1.01–1.19) | 0.98 (0.91–1.05) | 1.02 (0.91–1.13) | 1.05# (0.99–1.12) |
Type of relationship
| ||||||
Percentage household members (for every additional 10%) | 1.06 (0.93–1.20) | 1.25** (1.05–1.50) | 1.15* (1.03–1.29) | 0.96 (0.85–1.08) | 1.29*** (1.12–1.49) | 0.99 (0.90–1.09) |
Percentage family members (for every additional 10%) | 1.02 (0.94–1.10) | 1.06 (0.92–1.22) | 1.08# (0.99–1.17) | 0.98 (0.92–1.04) | 1.04 (0.94–1.16) | 1.03(0.97–1.09) |
Percentage friends (for every 10% less) | 1.05 (0.96–1.14) | 1.14 (0.96–1.35) | 1.14** (1.04–1.26) | 1.00 (0.93–1.08) | 1.08 (0.95–1.22) | 1.04(0.98–1.11) |
Living alone | 1.00 (0.66–1.52) | 0.59 (0.24–1.44) | 0.87 (0.54–1.39) | 1.59# (0.98–2.60) | 1.84# (0.89–3.81) | 1.94**(1.29–2.93) |
Lack of social participation | 1.60** (1.12–2.27) | 1.72 (0.84–3.55) | 2.12*** (1.44–3.13) | 1.31 (0.93–1.85) | 1.57# (0.92–2.68) | 1.42* (1.06–1.90) |
Functional characteristics of the social network | ||||||
Less informational supporta
| 0.98 (0.88–1.10) | 1.13 (0.92–1.40) | 1.09 (0.97–1.23) | 1.02 (0.92–1.12) | 1.12 (0.96–1.31) | 1.02 (0.93–1.10) |
Less emotional support (discomfort) a
| 1.04 (0.94–1.16) | 1.22# (0.97–1.53) | 1.12# (0.99–1.27) | 1.08 (0.98–1.21) | 1.17# (0.98–1.41) | 1.06 (0.96–1.16) |
Less emotional support (important decisions) a
| 1.08 (0.96–1.21) | 1.34* (1.06–1.69) | 1.11# (0.98–1.26) | 1.06 (0.95–1.18) | 1.19* (1.00–1.43) | 1.11* (1.01–1.22) |
Less practical support (jobs)a
| 1.11# (1.00–1.24) | 1.19 (0.94–1.50) | 1.16* (1.02–1.32) | 1.03 (0.93–1.15) | 1.21* (1.01–1.46) | 1.04 (0.95–1.14) |
Less practical support (sickness) a
| 1.07 (0.95–1.20) | 1.45* (1.07–1.96) | 1.21* (1.05–1.41) | 1.08 (0.96–1.21) | 1.25* (1.02–1.54) | 1.13* (1.02–1.25) |