Capsule Commentary on Raghavan et al., Incident Type 2 Diabetes Risk is Influenced by Obesity and Diabetes in Social Contacts: A Social Network Analysis
J Gen Intern Med
CAPSULE COMMENTARIES Capsule Commentary on Raghavan et al., Incident Type 2 Diabetes Risk is Influenced by Obesity and Diabetes in Social Contacts: A Social Network Analysis
Namratha R. Kandula ) 0
0 Feinberg School of Medicine, Division of General Internal Medicine, Northwestern University , Chicago, IL , USA
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S behavior, physical and mental health, and mortality.1 In
ocial relationships are established correlates of health
this issue of JGIM, Raghavan et al. report an association
between having a social contact with diabetes or with obesity
and incident type 2 diabetes mellitus during 37 years of
follow-up of a subgroup from the Framingham Offspring
Study.2 The study includes baseline and follow-up data from
4797 participants and 692 incident type 2 diabetes cases. A
strength of this study is the ability to test the temporal
association between the independent variable and the outcome
variable at multiple times.
While studies have shown that obesity and type 2 diabetes
clusters in social networks,3 the current study uses
longitudinal data to delineate associations between specific types of
social contacts and incident type 2 diabetes. The main finding
was that incident diabetes in Framingham participants was
associated with diabetes (but not obesity) in participants’
siblings and obesity (but not diabetes) in participants’ spouses.
Their finding that the association differed depending on
whether the social contact was a spouse or a sibling generates
hypotheses about how behaviors may spread over time and
influence type 2 diabetes risk. For example, a spouse may
facilitate or inhibit daily health behaviors that influence
diabetes risk, whereas siblings share genetic risk and early life
exposures.
This study raises an important question, BWhere do we
begin to engage social relationships in type 2 diabetes
prevention?^ For clinicians, this study reaffirms the
importance of asking patients about health risks of spouses, siblings
and others who may be important. This information may
help identify patients at particularly high risk and lead
to discussions about who influences the patient’s health
behaviors. It remains unknown, however, if interventions
that leverage social ties can improve health.4 Research is
needed to identify the mechanistic links between social
relationships and health outcomes and to answer key
questions including: who in a person’s social network
is most influential for behavior change; how do
contextual factors affect the influence of social relationships on
health; and how is social influence transmitted? For
now, social relationships remain an untapped resource
for improving health.
Compliance with ethical standards:
1. House JS , Landis KR , Umberson D. Social relationships and health . Science . 1988 ; 241 : 540 - 545 .
2. Raghavan S , Pachucki MC , Chang Y , Porneala B , Fox CS , Dupuis J , Meigs JB . Incident type 2 diabetes risk is influenced by obesity and diabetes in social contacts: a social network analysis . J Gen Intern Med . 2016 . doi:10. 1007/s11606- 016 - 3723 -1.
3. Pancoska P , Buch S , Cecchetti A , Parmanto B , Vecchio M , Groark S , Paulsen S , Bardwell G , Morton C , Chester A , Branch R. Family networks of obesity and type 2 diabetes in rural appalachia . Clin Transl Sci . 2009 ; 2 : 413 - 421 .
4. Shaya FT , Chirikov VV , Howard D , Foster C , Costas J , Snitker S , Frimpter J , Kucharski K. Effect of social networks intervention in type 2 diabetes: a partial randomised study . J Epidemiol Community Health . 2014 ; 68 : 326 - 332 . (...truncated)