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Enjoyment of life predicts reduced type 2 diabetes incidence over 12 years of follow-up: findings from the English Longitudinal Study of Ageing
  1. Laura Panagi1,
  2. Ruth A Hackett2,
  3. Andrew Steptoe1,
  4. Lydia Poole1
  1. 1 University College London, London, UK
  2. 2 King’s College London, London, UK
  1. Correspondence to Laura Panagi, University College London, UCL Gower Street, London WC1E 6BT, UK; laura.panagi.16{at}


Background Subjective well-being appears to be associated with reduced risk of type 2 diabetes (T2D). However, it is unknown whether this association is similar across different types of well-being. We examined the relationship between hedonic and eudaimonic well-being and incident T2D, and explored the role of sociodemographic, behavioural and clinical factors in these associations.

Methods We used data from 4134 diabetes-free participants from the English Longitudinal Study of Ageing (mean age =64.97). Enjoyment of life and purpose in life were assessed using items from the CASP-19 to reflect hedonic and eudaimonic well-being, respectively. Participants reported T2D diagnosis over 12 years. We used Cox proportional hazards regression analyses and also explored the percentage of association explained by different covariates.

Results Results revealed a protective role for enjoyment of life in T2D rate adjusting for sociodemographic (age, sex, wealth, ethnicity, marital status), behavioural (physical activity, smoking, alcohol consumption, body mass index) and clinical (hypertension, coronary heart disease and glycated haemoglobin) characteristics (HR =0.93, p=0.021, 95% CI (0.87, 0.99)). Sociodemographic, behavioural and clinical factors accounted for 27%, 27% and 18% of the association, respectively. The relationship between purpose in life and T2D was non-significant (adjusted HR =0.92, p=0.288, 95% CI (0.78, 1.08)).

Conclusion This study illustrates how the link between subjective well-being and T2D varies between well-being components. It also demonstrates that sociodemographic, behavioural and clinical factors partially explain this association. Intervention studies examining whether changes in enjoyment of life can help delay T2D onset are warranted.

  • Psychosocial factors
  • Diabetes
  • Longitudinal studies
  • Epidemiology

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  • Contributors LP made a substantial contribution to the design of the work, analysis and interpretation of data. LP drafted and revised the manuscript. RAH made a substantial contribution to the analysis and manuscript revisions. AS made a substantial contribution to the design of the work and manuscript revisions. LP made a substantial contribution to the analysis and manuscript revisions. All coauthors have given final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding Funding Statement: The English Longitudinal Study of Ageing is funded by the National Institute of Aging in the USA and a consortium of UK government departments coordinated by the Economic and Social Research Council. This work was supported by the Anastasios G. Leventis Foundation (LPa); and the UK Economic and Social Research Council (RAH, grant number ES/R005990/1; LPo, grant number ES/N001478/1).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.

  • Supplemental material This content has been supplied by the authors. It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the authors and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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