Long-term exposure to fine particulate matter (PM2.5) may significantly increase the risk of developing type 2 diabetes, according to a global study published in the Journal of Vascular Diseases. Analysing more than 200 million cumulative participant observations worldwide, researchers found that exposure to PM2.5 is associated with a 10% to 16% higher risk of developing type 2 diabetes. The findings highlight how air pollution extends beyond respiratory health and may also contribute to metabolic disorders.
Global Study Examines Link Between Air Pollution and Diabetes
The research, titled APEX-T2D (Association Between PM Exposure and Type 2 Diabetes Across the Cardiovascular-Kidney-Metabolic Continuum), analysed evidence from 13 previous major reviews covering more than 200 million cumulative participant observations.
The study included populations from North America, Europe, East Asia, South Asia, Latin America and Australia. It was co-authored by Dr. Anoop Misra, Padma Shri and Executive Chairman and Director of Diabetes and Endocrinology at Fortis C-Doc Hospital for Diabetes and Allied Sciences, New Delhi, along with Yashendra Sethi, Nirja Kaka, Saurabh Singhal, Manvi Vasudev and Giuseppe Biondi-Zoccai.
To assess the relationship between air pollution and diabetes, researchers followed internationally recognised scientific guidelines, including Cochrane and Joanna Briggs Institute (JBI) methodologies for umbrella reviews. They searched major scientific databases, including PubMed, Embase, Scopus and Web of Science, for relevant research published up to May 2026. The team also assessed the quality and reliability of the available evidence using standardised evaluation frameworks.
PM2.5 Exposure Associated with Higher Diabetes Risk
The findings revealed a consistent association between long-term PM2.5 exposure and an increased risk of developing type 2 diabetes. Across the major reviews examining new diabetes cases, researchers observed a 10% to 16% rise in diabetes risk for every 10 micrograms per cubic metre increase in PM2.5 concentration.
Furthermore, the analysis linked air pollution exposure to higher diabetes prevalence, increased blood sugar levels and related metabolic complications.
Importantly, the association remained evident even among populations living in areas classified as having relatively cleaner air. Since outdoor air pollution affects large populations, even a modest increase in individual risk could contribute to millions of additional diabetes cases worldwide.
The researchers also highlighted the growing public health implications for South and East Asia, where high levels of urban air pollution pose significant environmental and health challenges.
Experts Highlight Air Pollution’s Impact on Metabolic Health
Commenting on the findings, Dr. Anoop Misra said that air pollution should not be viewed only as an environmental or respiratory health concern. Instead, healthcare professionals and policymakers should consider its potential impact across the broader cardiovascular-kidney-metabolic (CKM) continuum.
He highlighted that severe air pollution in major South Asian cities could contribute to the growing burden of diabetes. Therefore, improving air quality should become an important part of diabetes prevention strategies.
Similarly, Yashendra Sethi, first author of the APEX-T2D study, emphasised that environmental conditions significantly influence overall health. He noted that air pollution affects not only the lungs but also cardiovascular and metabolic health, potentially increasing the risk of type 2 diabetes.
He further stressed that India must address environmental pollution alongside metabolic health challenges to strengthen its efforts against the growing diabetes burden.
Researchers Call for Stronger Air Quality Measures
Based on the findings, researchers have called for a broader approach to public health policies. While existing air quality guidelines primarily focus on protecting cardiovascular and respiratory health, the study highlights the need to consider metabolic health as well.
Experts recommend strengthening air quality monitoring, implementing stricter emission standards and incorporating environmental risk factors into national healthcare and diabetes prevention policies. The findings are particularly relevant ahead of World Diabetes Day on November 14, highlighting the importance of addressing environmental factors alongside lifestyle and other established diabetes risk factors.
As per the company press release, the global findings reinforce the need to recognise air pollution as a potential contributor to the rising burden of type 2 diabetes and to integrate cleaner air initiatives into broader metabolic health and disease prevention strategies.