Long-term PM2.5 exposure linked to 10-16% higher diabetes risk: Study

Global review covering over 200 million participant observations links prolonged PM2.5 exposure to higher Type 2 diabetes risk, highlighting metabolic health concerns in polluted regions

Long-term exposure to fine particulate matter (PM2.5) is associated with a 10-16 per cent higher risk of developing Type 2 diabetes for every 10 micrograms per cubic metre increase in pollution levels, according to a global study published in the Journal of Vascular Diseases.

 

The research, which analysed 13 previous reviews covering more than 200 million cumulative participant observations, found consistent evidence linking air pollution to a higher incidence of diabetes, elevated blood sugar levels and related metabolic complications.

 

The findings suggest that the health impact of air pollution extends beyond respiratory and cardiovascular diseases, with long-term exposure also potentially affecting metabolic health. The researchers said the findings have particular implications for highly polluted regions such as South Asia, where diabetes rates are already a major public health concern.

 

 

The study, titled APEX-T2D (Association Between PM2.5 Exposure and Type 2 Diabetes Across the Cardiovascular-Kidney-Metabolic Continuum), examined evidence from populations across North America, Europe, East and South Asia, Latin America and Australia. The review included studies from India, Bangladesh and Sri Lanka, among other countries.

 

The research was co-authored by Anoop Misra, executive chairman and director of diabetes and endocrinology at Fortis C-DOC Hospital, New Delhi, along with Yashendra Sethi, Nirja Kaka, Saurabh Singhal, Manvi Vasudev and Giuseppe Biondi-Zoccai.

 

The researchers found that the association between PM2.5 exposure and the risk of developing Type 2 diabetes remained consistent across the major reviews examined. The increased risk was also observed among populations living in areas with relatively lower pollution levels.

 

Given the widespread exposure to outdoor air pollution, even a modest increase in individual risk could translate into a substantial number of additional diabetes cases globally, the study said.

 

"The study underscores the importance of viewing air pollution not only as an environmental and respiratory health concern, but also as a potential consideration within the broader cardiovascular-kidney-metabolic (CKM) continuum. When we look at heavy pollution in major South Asian cities, the public health toll on diabetes rates is immense. Air quality management must become a core part of diabetes prevention," Misra said.

 

Sethi, the study's first author, said air pollution affects multiple aspects of health, including cardiovascular and metabolic systems, and should be considered while addressing the rising burden of diabetes.

 

"If India wants to tackle both diabetes and pollution, we must improve metabolic health and clean up our environment. We cannot fight diabetes while ignoring the air we breathe," he said.

 

The study followed international guidelines for umbrella reviews, including the Cochrane and Joanna Briggs Institute methodologies, and used PRISMA 2020 and PRIOR reporting standards. The researchers searched major scientific databases, including PubMed, Embase, Scopus and Web of Science, for relevant studies published up to May 2026.

 

The authors said air quality policies have traditionally focused on protecting respiratory and cardiovascular health, but metabolic disorders should also be considered in public health planning. They called for stronger air quality monitoring, tighter emission standards and the inclusion of environmental risk factors in national healthcare policies.