Vallianou, Natalia G.
Geladari, V, Eleni
Kounatidis, Dimitris
and Geladari, V, Chara
Stratigou, Theodora
Dourakis, Spyridon P.
and Andreadis, Emmanuel A.
Dalamaga, Maria
Worldwide, diabetes mellitus (DM) represents a major public-health
problem due to its increasing prevalence in tandem with the rising trend
of obesity. However, climate change, with its associated negative health
effects, also constitutes a worrisome problem. Patients with DM are
experiencing more visits to emergency departments, hospitalizations,
morbidity and mortality during heat waves at ever-increasing numbers.
Such patients are particularly vulnerable to heat waves due to impaired
thermoregulatory mechanisms in conjunction with impaired autonomous
nervous system responses at high temperatures, electrolyte imbalances
and rapid deterioration of kidney function, particularly among those
aged > 80 years and with preexisting chronic kidney disease (CKD).
Moreover, exposure to cold temperatures is associated with increased
rates of acute myocardial infarction as well as poor glycaemic control,
although results are conflicting regarding cold-related mortality among
patients with DM.
In addition to extremes of temperature, air pollution as a consequence
of the climate crisis may also be implicated in the increased prevalence
and incidence of DM, particularly gestational DM (GDM), and lead to
deleterious effects in patients with DM. Thus, more large-scale studies
are now required to elucidate the association between specific air
pollutants and risk of DM.
This review presents the currently available evidence for the
detrimental effects of climate change, particularly those related to
weather variables, on patients with DM (both type 1 and type 2) and GDM.
Specifically, the effects of heat waves and extreme cold, and
pharmaceutical and therapeutic issues and their implications, as well as
the impact of air pollution on the risk for DM are synthesized and
discussed here. (C) 2020 Elsevier Masson SAS. All rights reserved.
(EN)
