Long-Term Exposure to Ambient Air Pollution and Type 2 Diabetes in Adults

PURPOSE OF REVIEW We identified 24 publications from January 2010 until September 2018 in the peer-reviewed literature addressing the relationship of long-term air pollution exposures and type 2 diabetes-related morbidity and mortality among adults. We examine key methodological issues, synthesize findings, and address study strengths and limitations. We also discuss biological mechanisms, policy implications, and future research needed to address existing knowledge gaps. RECENT FINDINGS In general, the studies included in this review employed rigorous methodology with large sample sizes, appropriate study designs to maximize available cohort study or administrative data sources, and exposure modeling that accounted for spatial patterns in air pollution levels. Overall, studies suggested increased risks of type 2 diabetes-related morbidity and mortality among adults associated with increased exposures; however, findings were not uniformly positive nor statistically significant. SUMMARY Current research is particularly limited regarding the biological mechanisms involved and the relationship between ozone and diabetes. Additionally, more research is needed to distinguish clearly the effects of nitrogen oxides from those of other pollutants and to identify potential subpopulations with greater susceptibility for certain pollutant exposures. A better understanding of the potential link between long-term ambient air pollution exposures and type 2 diabetes may provide opportunities for the reduction of health risks and inform future interventions for environmental protection and diabetes management