How Air Pollution Contributes To India’s Diabetes Epidemic

Most people understand that eating healthy, staying active, maintaining healthy body weight, and adopting healthy lifestyle habits can help to prevent or manage diabetes quite effectively. However, most of us overlook the impact that air quality and pollution have on diabetes risk and outcomes. There is a growing body of research, which shows that air quality significantly increases the risk of diabetes and makes the condition harder to manage. 

Air Pollution And Diabetes In India

There has been little research on the impact of air pollution on diabetes in India, but a recent study by researchers from Sardar Patel Medical College, in Bikaner, Rajasthan sought to address this knowledge gap. The findings of their study were published in the Journal of the Association of Physicians of India and confirmed suspicions that long-term exposure to air pollution impairs glucose tolerance and is associated with an increased prevalence of diabetes. 

Global Impact Of Air Pollution On Diabetes

Findings similar to those from India have been reported across the world. The most notable of these was a large-scale study that appeared in Lancet Planetary Health, which estimates that 3.2 million diabetes cases across the world can be directly linked to high air pollution levels in 2016 alone. The highest burden of air pollution in the context of diabetes is also felt by low- and lower- to middle-income countries such as India. 

How Air Quality Affects Diabetes

While the impact of air pollution on diabetes risk and complications is clear from research, the exact role that it plays is still being understood. Research so far suggests that air pollution increases the risk of diabetes as it alters the balance of gut bacteria, reducing gut microbiome diversity. This impairs the process of food digestion and also adversely impacts the gut, increasing the risk of inflammation. This in turn is linked to a decrease in insulin sensitivity and reduced insulin production, increasing the risk of diabetes.

Additionally, fine particles in polluted air include metals and toxins that can cause inflammation in the lungs and the rest of the body. This type of chronic inflammation is already known to be a diabetes risk factor.   

Effects Of Air Pollution On Diabetes Management

Particulate matter from smoke, especially from burning wood and coal, is known to be problematic across large swathes of India. Studies of the impact of wildfires in other parts of the world show that smoke has an adverse impact on diabetes patients, which is also relevant to India’s population. High levels of fine particulate matter in smoke are associated with a rise in incidences of both high and low blood sugar emergencies. 

Diabetes patients are also more vulnerable to air pollution because air quality has a direct impact on cardiovascular health. Heart disease is a common complication in diabetes and studies show that air pollution doubles the risk of heart disease-related hospital admissions among diabetes patients.

What You Can Do

While air pollution may be a problem that requires societal and governmental action, there are steps that you can take as an individual. Try to limit exposure to air pollution by avoiding busy roadways and areas that have heavy traffic and poor air quality. Exercise outdoors at times when air quality is better. Moreover, remember that air pollution alone is not a cause for diabetes. So, while you should be aware of the risk, make sure to control other risk factors, such as poor diet, sedentary lifestyle, obesity, and smoking. 

References:

• https://pubmed.ncbi.nlm.nih.gov/35443338/
• https://www.thelancet.com/journals/lanpla/article/PIIS2542-5196(18)30140-2/fulltext
• https://pubmed.ncbi.nlm.nih.gov/32135388/
• https://www.nejm.org/doi/full/10.1056/NEJMsr2028985
• https://journals.lww.com/epidem/Fulltext/2002/09000/Cardiovascular_Damage_by_Airborne_Particles__Are.16.aspx