Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study

Background Previous research has linked solitary living to various adverse health outcomes, but its association with diabetic complications among individuals with type 2 diabetes mellitus (T2DM) remains underexplored. We examined the risk of endstage kidney disease (ESKD) in individuals with diabete...

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Main Authors: Kyunghun Sung, Jae-Seung Yun, Bongseong Kim, Hun-Sung Kim, Jae-Hyoung Cho, Yong-Moon Mark Park, Kyungdo Han, Seung-Hwan Lee
Format: Article
Language:English
Published: Korean Diabetes Association 2025-07-01
Series:Diabetes & Metabolism Journal
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Online Access:http://e-dmj.org/upload/pdf/dmj-2024-0578.pdf
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author Kyunghun Sung
Jae-Seung Yun
Bongseong Kim
Hun-Sung Kim
Jae-Hyoung Cho
Yong-Moon Mark Park
Kyungdo Han
Seung-Hwan Lee
author_facet Kyunghun Sung
Jae-Seung Yun
Bongseong Kim
Hun-Sung Kim
Jae-Hyoung Cho
Yong-Moon Mark Park
Kyungdo Han
Seung-Hwan Lee
author_sort Kyunghun Sung
collection DOAJ
description Background Previous research has linked solitary living to various adverse health outcomes, but its association with diabetic complications among individuals with type 2 diabetes mellitus (T2DM) remains underexplored. We examined the risk of endstage kidney disease (ESKD) in individuals with diabetes living alone (IDLA). Methods This population-based cohort study used the National Health Information Database of Korea, which included 2,432,613 adults with T2DM. Household status was determined based on the number of registered family members. IDLA was defined as continuously living alone for 5 years or more. A multivariable Cox proportional hazards model was used to evaluate the association between living alone and the risk of developing ESKD. Results During a median follow-up of 6.0 years, 26,691 participants developed ESKD, with a higher incidence observed in the IDLA group than in the non-IDLA group. After adjusting for confounding variables, the hazard ratio for ESKD in the IDLA group was 1.10 (95% confidence interval, 1.06 to 1.14). The risk of ESKD was particularly elevated in younger individuals, those without underlying chronic kidney disease, with longer durations of living alone, and with low household income. Adherence to favorable lifestyle behaviors (no smoking, no alcohol consumption, and engaging in regular exercise) was associated with a significantly lower risk of ESKD, with a more pronounced effect in the IDLA group. Conclusion Living alone was associated with a higher risk of ESKD in individuals with T2DM. Tailored medical interventions and social support for IDLA are crucial for the prevention of diabetic complications.
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spelling doaj-art-a033b40a23b249feabb69e6eb4bbcbf42025-08-20T03:17:55ZengKorean Diabetes AssociationDiabetes & Metabolism Journal2233-60792233-60872025-07-0149486287210.4093/dmj.2024.05782943Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based StudyKyunghun Sung0Jae-Seung Yun1Bongseong Kim2Hun-Sung Kim3Jae-Hyoung Cho4Yong-Moon Mark Park5Kyungdo Han6Seung-Hwan Lee7 Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, KoreaBackground Previous research has linked solitary living to various adverse health outcomes, but its association with diabetic complications among individuals with type 2 diabetes mellitus (T2DM) remains underexplored. We examined the risk of endstage kidney disease (ESKD) in individuals with diabetes living alone (IDLA). Methods This population-based cohort study used the National Health Information Database of Korea, which included 2,432,613 adults with T2DM. Household status was determined based on the number of registered family members. IDLA was defined as continuously living alone for 5 years or more. A multivariable Cox proportional hazards model was used to evaluate the association between living alone and the risk of developing ESKD. Results During a median follow-up of 6.0 years, 26,691 participants developed ESKD, with a higher incidence observed in the IDLA group than in the non-IDLA group. After adjusting for confounding variables, the hazard ratio for ESKD in the IDLA group was 1.10 (95% confidence interval, 1.06 to 1.14). The risk of ESKD was particularly elevated in younger individuals, those without underlying chronic kidney disease, with longer durations of living alone, and with low household income. Adherence to favorable lifestyle behaviors (no smoking, no alcohol consumption, and engaging in regular exercise) was associated with a significantly lower risk of ESKD, with a more pronounced effect in the IDLA group. Conclusion Living alone was associated with a higher risk of ESKD in individuals with T2DM. Tailored medical interventions and social support for IDLA are crucial for the prevention of diabetic complications.http://e-dmj.org/upload/pdf/dmj-2024-0578.pdfdiabetes mellituskidney failure, chronicsocial isolation
spellingShingle Kyunghun Sung
Jae-Seung Yun
Bongseong Kim
Hun-Sung Kim
Jae-Hyoung Cho
Yong-Moon Mark Park
Kyungdo Han
Seung-Hwan Lee
Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study
Diabetes & Metabolism Journal
diabetes mellitus
kidney failure, chronic
social isolation
title Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study
title_full Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study
title_fullStr Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study
title_full_unstemmed Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study
title_short Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study
title_sort risk of end stage kidney disease in individuals with diabetes living alone a large scale population based study
topic diabetes mellitus
kidney failure, chronic
social isolation
url http://e-dmj.org/upload/pdf/dmj-2024-0578.pdf
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