Diabetes and Air Pollution

Is diabetes a risk factor for air pollution effects?

Yes, according to the EPA. In its course for health professionals, the EPA lists people with diabetes, alongside people with heart or lung disease, older adults, children and people of lower socioeconomic status, as patients who are more likely to be affected by particle pollution and who benefit most from reducing their exposure.^[2]

The American Lung Association explains why: people living with chronic diseases, including cardiovascular disease and diabetes, already live with physical challenges, and the cellular injury and inflammation caused by breathing polluted air puts extra stress on organs that are already affected by disease. It says this can lead to worse symptoms, more medication use, more emergency visits and hospital stays, and even premature death.^[3]

Can air pollution contribute to developing diabetes?

The research is still developing, but the major sources point in the same direction. The American Lung Association lists a "higher likelihood of developing diabetes" among the effects research has linked to year-round exposure to particle pollution.^[4] The National Institute of Environmental Health Sciences (part of NIH) lists diabetes mellitus and obesity among the public-health concerns related to high air pollution exposure, and notes that research on these effects is still advancing.^[5]

These are population-level associations from research. They don't mean air pollution caused any one person's diabetes, and they don't replace the well-known risk factors your doctor screens for.

Which pollutant matters most?

Fine particle pollution (PM2.5). The EPA says particles smaller than 10 micrometers can get deep into the lungs and some may even get into the bloodstream, affecting both the lungs and the heart.^[6] The American Lung Association's list of people at higher risk from particle pollution includes "people who are obese or have diabetes."^[4]

What to do when the AQI is orange or higher

When the AQI for particle pollution is 101–150 (Code Orange, "unhealthy for sensitive groups"), the EPA says people with diabetes, along with the other sensitive groups, are advised to reduce prolonged or heavy exertion.^[2]In practice, the EPA describes moderate exertion as things like climbing stairs or playing tennis.^[2]

• Check the forecast. Look up your local AQI before planning outdoor exercise. The AQI and outdoor exercise guide explains the categories.
• Avoid busy roads. The EPA says walkers, runners and cyclists can reduce particle exposure by planning times and routes away from busy roads, and drivers can set ventilation to "recirculate" on busy roads.^[2]
• Filter indoor air. The EPA says a portable air cleaner with a clean air delivery rate (CADR) large enough for the room can reduce indoor particles, and that several studies with portable HEPA cleaners found small improvements in cardiovascular and respiratory health.^[7] It also advises avoiding air cleaners that intentionally produce ozone.^[7]
• Keep your usual care plan. Ask your doctor whether your diabetes or any heart condition changes how you should respond to poor air quality.

What the AQI colors mean

AirNow reports the Air Quality Index (AQI) for five pollutants regulated under the Clean Air Act: ground-level ozone, particle pollution (PM2.5 and PM10), carbon monoxide, sulfur dioxide and nitrogen dioxide.^[1]

• Green, 0–50 (Good): air pollution poses little or no risk.^[1]
• Yellow, 51–100 (Moderate): acceptable, but there may be a risk for people who are unusually sensitive to air pollution.^[1]
• Orange, 101–150 (Unhealthy for Sensitive Groups): members of sensitive groups may experience health effects; the general public is less likely to be affected.^[1]
• Red, 151–200 (Unhealthy) and above: some members of the general public may experience health effects, and sensitive groups may experience more serious effects.^[1]

Check today's reading for your area on the city air quality pages or at AirNow.gov.