Association Between Type 2 Diabetes and Chronic Arsenic Exposure in Bangladesh

Abstract

O-31B7-1 Background/Aims: Chronic exposure to inorganic arsenic in drinking water has been associated with type 2 diabetes (T2D). Most research has been ecological in nature and has focused on high levels of arsenic exposure with few studies directly measuring arsenic levels in drinking water as an index of arsenic exposure. The effect of low-to-moderate levels of arsenic exposure on diabetes risk is largely unknown. Aims: To determine the association between chronic arsenic exposure, as measured in drinking well water, and prevalent T2D in a representative sample of Bangladesh residents. Methods: The study is an analytical cross-sectional study of 1004 randomly selected men and women aged >30 years living in Bangladesh who had continuously consumed arsenic-contaminated drinking water for at least 6 months. T2D cases were defined using the new diagnostic criteria (fasting blood glucose >126 mg/dL) from the WHO guideline (WHO 2006), or a self-reported physician diagnosis of T2D. Results: A total of 1004 individuals participated in the study. The prevalence of T2D was 9% (95% CI: 7%–11%). After adjustment for diabetes risk factors, an increased risk of T2D was observed for arsenic exposure over 50 μg/L with those in the highest category having almost double the risk of T2D (OR = 2.1; 95% CI: 1.3–3.2). For most levels of arsenic exposure, the risk estimates are higher with longer exposure; a dose-response pattern was also observed. Conclusion: These findings suggest an association between chronic arsenic exposure through drinking water and T2D. Risks are generally higher with longer duration of arsenic exposure. The risk of T2D is highest among those who were exposed to the highest concentration of arsenic for more than 10 years.