Could Dirty Air Cause Diabetes?

Abstract

Diabetes is a growing epidemic, and it has become arguably one of the biggest health challenges of our time. Currently, more than 23 million Americans have diabetes, and the Centers for Disease Control and Prevention estimate that in the last 15 years, the number of people in the United States with diabetes has more than doubled. Diabetes is increasing at an alarming rate in Europe as well, and it is fast becoming a major health threat in developing countries such as India and China. Despite its high prevalence, however, diabetes remains somewhat of a mystery. Although type 1 diabetes mellitus could be attributed to insufficient insulin release by the β-cells of the pancreas, the origins of type 2 diabetes mellitus (which accounts for >90% of the cases of diabetes) remain obscure. Insulin resistance is a cardinal feature of type 2 diabetes mellitus; however, it is not clear how whole-body insulin resistance develops, which specific tissues are affected first and which ones later, and how metabolic changes in individual tissues contribute to the overall development of the disease and its many secondary complications. Article p 538 The origin of diabetes is equally complex. Although diabetes develops in genetically susceptible individuals, it is a complex trait and does not show simple mendelian inheritance. Because the rates of diabetes change with the environment in several population groups, it has been suggested that modifiable environmental factors and lifestyle choices account for more than 90% of adult-onset diabetes.1 Nevertheless, our understanding of the environmental causes of diabetes has remained rather rudimentary, being limited mostly to the impact of physical inactivity or unhealthy dietary choices. In this context, the study by Sun and coworkers published in the present issue of Circulation 2 is interesting because it provides new evidence showing that exposure to particulate air …