Air pollution increases adverse effect in individuals with type 2 diabetes, suggests study

A new study published in the journal of the Lancet eBiomedicine found that people with type 2 diabetes may be more susceptible to death from air pollution over an extended period of time, but, residential neighborhoods with green spaces may have a reductive impact. Diabetes will affect over 500 million people worldwide by 2021, with a 6.1% prevalence worldwide. It is a fast expanding global health problem. According to 2018 figures, the prevalence of diabetes in China is very high at 12.4%, which results in enormous financial burdens and healthcare expenses.

Comprehending all the risk factors for diabetes is crucial, as it is linked to an increased chance of death from other conditions, including cardiovascular disease. Numerous studies using epidemiological methods have shown a connection between exposure to air pollution and higher cause-specific mortality in the general population, such as deaths from diabetes and its complications. Therefore, Chunfeng Wu and team conducted this study to evaluate the long-term effects of exposure to green spaces and home air pollution on cause-specific mortality in people with type 2 diabetes mellitus (T2DM).

A total of 1,74,063 newly diagnosed T2DM subjects from a prospective cohort registered in Shanghai, China between 2011 and 2013 were included in this study. Satellite-based exposure models were used to calculate the annual residential levels of air pollutants, such as nitrogen dioxide (NO2), fine (PM2.5) and coarse (PM2.5–10) particulate matter, and the normalized difference vegetation index (NDVI). The study concentrated on mortality from both general and particular causes like cancer, cardiovascular disease, respiratory disorders, and problems related to diabetes.

22,205 fatalities were reported over a median follow-up of 7.9 years in this research. While PM2.5-10 had no discernible effects, higher exposure to PM2.5 was substantially linked to increased risks for all mortality outcomes. Diabetes was shown to have the greatest connections with peripheral vascular disorders and gastrointestinal cancer with PM2.5.

At values higher than around 45 μg/m³, NO2 started to have an impact,, where lung and gastrointestinal cancers showed the strongest correlations. With HRs ranging from 0.76 to 1.00, every interquartile range rise in NDVI was associated with a lower risk of mortality from a variety of causes. Reductions in PM2.5 and NO2 were a significant and partial mediating factor in the link between greenness and mortality. Overall, individuals with T2DM are more vulnerable to the negative health impacts of air pollution, and green infrastructure has the potential to protect them.

Reference:

Wu, C., Liu, J., Li, Y., Qin, L., Gu, R., Feng, J., Xu, L., Meng, X., Chen, J., Chen, R., Shi, Y., & Kan, H. (2024). Association of residential air pollution and green space with all-cause and cause-specific mortality in individuals with diabetes: an 11-year prospective cohort study. In eBioMedicine (Vol. 108, p. 105376). Elsevier BV. https://doi.org/10.1016/j.ebiom.2024.105376