Diabetes may be linked to environment quality

Environmental quality and exposure to pollution may play a small part in the development of metabolic diseases, such as diabetes, a new study has found.

Using the Environmental Quality Index (EQI), researchers assessed multifactorial, county-level ambient environmental exposures. The information was then linked to county-level annual age-adjusted, population-based diabetes prevalence estimates. Obesity, leisure time and physical inactivity were included as covariates.

A total of 3,134 counties were represented in the analysis, of which 34.7 percent and 33.7 percent were metropolitan-urbanized and less-urbanized, respectively. On the other hand, 21.3 percent were thinly populated, while the remaining 10.3 percent of the counties were classified as nonmetropolitan urbanized. The mean total diabetes prevalence rate was 13.58±2.44 per 100,000 population.

Controlling for covariates, researchers found that in the overall sample, poor cumulative environmental quality correlated significantly with lower total diabetes prevalence (prevalence difference [PD], –1.36, 96 percent CI, –1.43 to –1.28). The same was true for diagnosed and undiagnosed diabetes.

However, stratifying according to rural-urban status revealed important differences. In less-urbanized (PD, 2.58. 2.46–2.71) and thinly populated (PD, 2.88, 2.74–3.01) counties, poor cumulative environmental quality significantly increased the prevalence of total diabetes. In metropolitan-urbanized areas, on the other hand, the correlation was null (PD, 0.07, –0.03 to 0.17).

Moreover, disaggregation according to EQI domains, and with respect to both domains and rural-urban status, further revealed variations in the interplay between environmental quality and the prevalence of diabetes. This suggests that further studies targeting specific interactions within this complex web are needed.