Key result
Long-term exposure to higher PM2.5 was associated with higher odds of distal sensorimotor polyneuropathy in adults with recent-onset type 2 diabetes (OR 1.46; 95% CI 1.01-2.10).
Why the study?
Air pollutants are linked to increased risk of diabetes-related comorbidities, but whether such exposures contribute to their early development remains unknown.
Does long-term exposure to air pollution increase cardiovascular risk and diabetes-related comorbidities in adults with recent-onset Type 1 and Type 2 diabetes?
Cohort (n=985)
Does long-term exposure to air pollution increase cardiovascular risk and diabetes-related comorbidities in adults with recent-onset Type 1 and Type 2 diabetes?
Odds Ratio: 1.46 (95% CI 1.01–2.1)
Long-term exposure to air pollution is associated with increased cardiovascular risk and microvascular complications early in the course of Type 2 diabetes.
Air pollution exposure warrants no practice change in early T2D; leaves open causal role in neuropathy.
Introduction and Objective: Air pollutants such as particulate matter (PM2.5, PM10) and nitrogen dioxide (NO2) have been linked to increased risk of diabetes-related comorbidities. However, whether such exposures contribute to the early development of comorbidities remains unknown. This study aims to determine whether long-term exposure to PM2.5, PM10 and NO2 is associated with diabetes-related comorbidities in individuals with recent-onset T1D and T2D and diabetes subtypes. Methods: Data are based on 985 adults from the German Diabetes Study (GDS; 358 with T1D, 627 with T2D, time since diagnosis <1 year). Diabetes-related risk factors and comorbidities included 10-year cardiovascular disease (CVD) risk (SCORE2-Diabetes), urinary albumin as an indicator of impaired kidney function and clinical diagnosis of distal sensorimotor polyneuropathy (DSPN). Air pollution exposures were derived from the data provided by the German Federal Environment Agency. Exposures to PM2.5, PM10 and NO2 were calculated as average of exposures during the 5 years preceding study enrolment. Each exposure-outcome pair were estimated using regression adjusted for age, sex, smoking, socioeconomic status, season and physical activity. Results: In participants with T2D, exposure to higher PM2.5 per interquartile range increase was associated with higher CVD risk (exp(β) = 1.12 (95% CI 1.03-1.22)), higher urinary albumin (exp(β) = 1.78 (1.49-2.13)) and higher odds of DSPN (OR = 1.46 (1.01-2.10)). Similar associations were observed for PM10, and NO2. Among individuals with T1D, higher exposures to PM2.5 and PM10 were also associated with higher urinary albumin (exp(β) = 1.52 (1.20-1.93) and 1.32 (1.05-1.65), respectively). Exploratory analyses suggested differences in associations across diabetes subtypes. Conclusion: Long-term exposure to air pollution was consistently associated with an increased burden of diabetes-related risk factors and comorbidities already in recent-onset T2D, while associations were less consistent in T1D. Disclosure N. Singh: None. C. Wigmann: None. S. Kress: None. O. Zaharia: None. K.B. Bódis: Other - travel support; Ended; Sanofi. Other - lecture honoraria; Ended; Pfizer Inc. S. Trenkamp: None. B. Sun: None. G.J. Bönhof: None. K.A. Jandeleit-Dahm: None. S. Schlesinger: Other - Speaker honorarium; Ended; Novo Nordisk. R. Wagner: Advisory Panel; Current; Sanofi. Speaker's Bureau; Ended; Daiichi Sankyo, Novo Nordisk. T. Schikowski: None. M. Roden: Advisory Panel; Current; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly, Madrigal Pharmaceuticals, Inc., Novo Nordisk, Sanofi, Echosens. C. Herder: None. Funding The German Diabetes Center initiated and financed the German Diabetes Study (GDS), which is funded by the German Federal Ministry of Health (Berlin, Germany), the Ministry of Innovation, Science, Research and Technology of the state North Rhine-Westphalia (Düsseldorf, Germany) and grants from the Federal Ministry of Research, Technology and Space (BMFTR) to the German Centre for Diabetes Research e. V. (DZD). M.R. is further supported by grants from the European Funds for Regional Development (EFRE-0400191), EUREKA Eurostars-2 (E! 113230 DIAPEP), European Community (HORIZON-HLTH-2022-STAYHLTH-02-01: P.A), the German Science Foundation (DFG; GRK 2576 vivid) and the Schmutzler Stiftung. The IUF is funded by the Ministry of Culture and Science of North Rhine-Westphalia (MKW) and the Federal Ministry of Research, Technology and Space (BMFTR).
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SINGH et al. (2026) conducted a cohort in Recent-onset Type 1 and Type 2 Diabetes (n=985). Long-term exposure to air pollution (PM2.5, PM10, NO2) vs. Lower exposure levels was evaluated on Clinical diagnosis of distal sensorimotor polyneuropathy (DSPN) in T2D (OR 1.46, 95% CI 1.01-2.10). Long-term exposure to higher PM2.5 was associated with higher odds of distal sensorimotor polyneuropathy in adults with recent-onset type 2 diabetes (OR 1.46; 95% CI 1.01-2.10).
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