something’s in the air

Something’s in the Air

Air pollution has been ranked as the leading environmental health threat worldwide, particularly in developing countries. Ample evidence has surfaced indicating that ambient air pollution may increase the risk of diabetes. Several human studies have explored the potential correlation between air pollution and diabetes. These studies found that the possible biological pathways include autonomic nervous system imbalances, oxidative stress, adipose inflammation, glucose metabolism, endothelial dysfunction, alterations in insulin sensitivity and glycosylated haemoglobin metabolism. 

Why This Study is Like a Breath of Fresh Air

A majority of the studies were done in North America and Europe, with a small fraction run in developing countries where air pollution concentration and diabetes prevalence are far higher. The issue with previous studies is that they were not verified by doctors, and very few considered glucose and insulin homeostatic markers. Therefore, this is the largest epidemiological study on the associations of ambient air pollution with diabetes and glucose-homoeostasis markers in a developing country. Furthermore, the study was from 33CCHS (located in China) where air pollution was severe. Finally, this is the first study ever to explore the diabetogenic effects of PM1

What They Found

  • Long-term exposure to air pollution was associated with increased risk of diabetes in the Chinese population, particularly in individuals who were younger, overweight or obese.
  • Diabetogenic effects of PM10 and NOappeared to be stronger than other air pollutants, and younger and overweight or obese participants appeared to be more susceptible to the diabetogenic effects of air pollutants than the older subgroups and those with normal bodyweight. 
  •  Exposure to air pollution might adversely affect glucose homoeostasis and consequently increase the risk of developing diabetes in China, along with other middle-income countries. 

Given the limitations of the study, however, more research needs to be conducted with more precise air pollution measurements in order to confirm these findings.  Considering the coexistence of both a diabetes epidemic and severe air pollution worldwide, the positive associations observed in this study and those done previously indicate an urgent need for governments to develop effective prevention and intervention policies to protect people from the adverse health effects of ambient air pollution.


  • Yang , B., Qian , P., Li, S., Chen, G., Bloom, M., & Elliot, M. (2018, February 1). Ambient Air Pollution in Relation to Diabetes and Glucose-Homoeostasis Markers in China: A Cross-Sectional Study with Findings from the 33 Communities Chinese Health Study. Retrieved from
  • Forouzanfar MH, Afshin A , Alexander LT, et al.Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015.
  • Guan W-J, Zheng X-Y, Chung KF,Zhong N-S Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action.Lancet. 2016; 388: 1939-1951