Abstract
The relationship between diabetes mellitus and short-term exposure to extreme temperatures remains controversial. A systematic review and meta-analysis were performed to assess the association between extreme temperatures and diabetes mellitus morbidity and mortality. PubMed, Embase, the Cochrane Library, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched since inception to January 1, 2019, and updated on November 17, 2020. The results were combined using random effects model and reported as relative risk (RR) with 95% confidence interval (CI). In total, 32 studies met the inclusion criteria. (1) Both heat and cold exposures have impact on diabetes. (2) For heat exposure, the subgroup analysis revealed that the effect on diabetes mortality (RR=1.139, 95% CI: 1.089–1.192) was higher than morbidity (RR=1.012, 95% CI: 1.004–1.019). (3) With the increase of definition threshold, the impact of heat exposure on diabetes rose. (4) A stronger association between heat exposure and diabetes was observed in the elderly (≥ 60 years old) (RR=1.040, 95% CI: 1.017–1.064). In conclusion, short-term exposure to both heat and cold temperatures has impact on diabetes. The elderly is the vulnerable population of diabetes exposure to heat temperature. Developing definitions of heatwaves at the regional level are suggested.
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Acknowledgements
Funding from the Science and Technology Program of Gansu Province, Natural Science Foundation of Shanghai, and Cost-effectiveness analysis of electrical stimulation combined with bladder function training in the treatment of neurogenic bladder with spinal cord injury are gratefully acknowledged.
Funding
This study was funded by the Science and Technology Program of Gansu Province (20CX4ZA027), Natural Science Foundation of Shanghai (20JR5RA262), and Cost-effectiveness analysis of electrical stimulation combined with bladder function training in the treatment of neurogenic bladder with spinal cord injury (2020-RC-63).
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XS made the search strategy and wrote the article. LJ analyzed the data, assessed the risk of bias, and wrote the article. DZ wrote the article. XW searched articles and assessed the risk of bias. YM and YH selected studies and extracted data. XL and JT selected studies. YM and DZ wrote the protocol and registered at the PROSPERO. WH, AS, and YF checked data and results of RoB assessment. YZ made some suggestions for improvement of this article.
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Song, X., Jiang, L., Zhang, D. et al. Impact of short-term exposure to extreme temperatures on diabetes mellitus morbidity and mortality? A systematic review and meta-analysis. Environ Sci Pollut Res 28, 58035–58049 (2021). https://doi.org/10.1007/s11356-021-14568-0
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DOI: https://doi.org/10.1007/s11356-021-14568-0