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Environmental Chemicals and Type 2 Diabetes: An Updated Systematic Review of the Epidemiologic Evidence

  • Diabetes Epidemiology (SH Golden, Section Editor)
  • Published:
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Abstract

The burden of diabetes is increasing globally. Identifying novel preventable risk factors is an urgent need. In 2011, the U.S. National Toxicological Program (NTP) conducted a workshop to evaluate the epidemiologic and experimental evidence on the relationship of environmental chemicals with obesity, diabetes, and metabolic syndrome. Although the evidence was insufficient to establish causality, the NTP workshop review identified an overall positive association between some environmental chemicals and diabetes. In the present systematic review, our objective was to summarize the epidemiological research published since the NTP workshop. We identified a total of 29 articles (7 on arsenic, 3 on cadmium, 2 on mercury, 11 on persistent organic pollutants, 3 on phthalates, and 4 on bisphenol A), including 7 prospective studies. Considering consistency, temporality, strength, dose–response relationship, and biological plausibility (confounding), we concluded that the evidence is suggestive but not sufficient for a relationship between arsenic and persistent organic pollutants and is insufficient for mercury, phthalates, and bisphenol A. For cadmium, the epidemiologic evidence does not seem to suggest an association with diabetes. Important research questions include the need for additional prospective studies and the evaluation of the dose–response relationship, the role of joint exposures, and effect modification with other comorbidities and genetic variants.

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Acknowledgments

Supported by grants from the National Institute of Environmental Health Sciences (R01ES021367, P30ES03819) and the National Heart Lung and Blood Institute (R01HL090863).

Compliance with Ethics Guidelines

Conflict of Interest

Chin-Chi Kuo declares that he has no conflict of interest.

Katherine Moon declares that she has no conflict of interest.

Kristina A. Thayer declares that she has no conflict of interest.

Ana Navas-Acien has received travel/accommodations expenses covered or reimbursed from the ADA for the ADA annual meeting.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Chin-Chi Kuo.

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Kuo, CC., Moon, K., Thayer, K.A. et al. Environmental Chemicals and Type 2 Diabetes: An Updated Systematic Review of the Epidemiologic Evidence. Curr Diab Rep 13, 831–849 (2013). https://doi.org/10.1007/s11892-013-0432-6

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  • DOI: https://doi.org/10.1007/s11892-013-0432-6

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