Resident Physician University of Illinois at Chicago Chicago, Illinois, United States
Objective : Climate change is predicted to adversely impact human health in myriad ways, with increasing concerns regarding the impact of various climactic factors on chronic disease incidence, progression, complications, and management. To clarify the current state of knowledge, we conducted a scoping review to identify the knowledge gaps about the impact of climate change on diabetes.
Methods: We conducted a comprehensive literature search across PubMed, EMBASE, and Web of Science databases, combining terms related to "climate change" and "diabetes" from January 1, 2018, through July 10, 2023. In addition, the Journal of Climate Change and Health was hand searched. Inclusion criteria encompassed studies investigating the impact of extreme environmental conditions including heat, cold, and natural disasters on individuals affected by diabetes, including those focused on type 1, type 2, gestational, and pediatric diabetes. Primary-source, peer-reviewed human studies were the focus of this analysis, while animal studies, plant-based research, studies centered on pollution, and review articles were excluded. The screening process comprised two stages to determine the relevance of the identified studies. A total of 1991 unique articles underwent title and abstract screening. Of these, 158 articles underwent full-text review. A total of 73 articles met the inclusion criteria and were included in the review. Throughout the analysis, two independent reviewers evaluated each article for eligibility. Discrepancies were resolved through discussion and consensus between the reviewers.
Results: The predominant focus of the articles centered on heat-related health effects, notably highlighting deteriorating glycemic control, increased mortality rates, and more frequent emergency room visitations. While studies have examined mortality linked to heat, cold, and natural disasters, a notable proportion failed to specify or elucidate the precise causes of death. A significant gap existed in the exploration of diabetes-related complications and non-glycemic metabolic outcomes, with a limited number of articles addressing these aspects. Additionally, a substantial portion of the articles presented data sourced from developed countries, while there was a notable scarcity of studies focusing on low and middle-income countries.
Discussion/Conclusion: Available literature links climate change to various adverse outcomes among those with diabetes. However, current data is sparse regarding the effect of climate change on pediatric and gestational diabetes as well as non-glycemic metabolic derangements and diabetes-related complications. In addition, data is lacking from geographic regions predicted to suffer from the greatest impacts of climate change and those with the most rapidly rising rates of diabetes. Further research is needed to close these data gaps in order to improve policy and practice to mitigate the impact of climate change on those living with diabetes.
