Experiences of social isolation among older adults with type 2 diabetes mellitus: A qualitative study

Objective To explore the experiences of social isolation among older adults with type 2 diabetes mellitus and identify the individual, interpersonal, and environmental factors shaping these experiences. Design A descriptive qualitative study was conducted. Fourteen older adults with T2DM were recruited from the Department of Endocrinology of a tertiary hospital in Yichang, China, using purposive sampling. Methods Face-to-face semi-structured interviews were conducted, and data were analysed using qualitative content analysis. Results Three main themes were identified. The first theme, intrapersonal withdrawal, reflected illness-related loss, fear of disease progression and emotional loneliness. The second theme, relational disconnection, described constrained autonomy caused by overprotective family care, shrinking peer networks and insufficient psychosocial support in doctor-patient communication. The third theme, environmental exclusion, involved mismatched community services, inaccessible public spaces and diabetes-related stigma. These themes indicate that social isolation among older adults with T2DM is a multi-level process shaped by the interaction of physical and psychological distress, relational burden and environmental barriers. Conclusion Social isolation among older adults with T2DM is not merely a lack of social contact, but a complex experience involving individual vulnerability, weakened interpersonal connections and restricted opportunities for social participation. Healthcare professionals should pay attention to patients’ emotional loneliness, autonomy and social participation needs. Family- and community-based support should also be strengthened to create more inclusive and age-friendly environments for this population.