Underutilized and Under Threat: Environmental Policy as a Tool to Address Diabetes Risk

Abstract

Purpose of Review

Diabetes is a burgeoning threat to public health in the USA. Importantly, the burden of diabetes is not equally borne across society with marked disparities based on geography, race/ethnicity, and income. The etiology of global and population-specific diabetes risk remains incompletely understood; however, evidence linking environmental toxicants acting as endocrine-disrupting chemicals (EDCs), such as particulate matter and arsenic, with diabetes suggests that environmental policies could play an important role in diabetes risk reduction.

Recent Findings

Evidence suggests that disproportionate exposures to EDCs may contribute to subgroup-specific diabetes risk; however, no federal policies regulate EDCs linked to diabetes based upon diabetogenic potential. Nevertheless, analyses of European Union data indicate that such regulation could reduce diabetes-associated costs and disease burden.

Summary

Federal laws only regulate EDCs indirectly. The accumulating evidence linking these chemicals with diabetes risk should encourage policymakers to adopt stricter environmental standards that consider both health and economic impacts.

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Funding

This work was supported by the University of Chicago, the American Diabetes Association (1-17-JDF-033 to RMS), the National Institute of Diabetes and Digestive and Kidney Diseases (P30-DK-092949 to Dr. Jagai via pilot funding from the Chicago Center for Diabetes Translational Research), and the National Institute of Environmental Health Sciences (P30-ES-027792 supporting Dr. Sargis via the ChicAgo Center for Health and EnvironmenT (CACHET)). The authors graciously acknowledge the assistance of Samuel M. Fuchs for assistance with the generation of Fig. 1, Milestones in United States Environmental Policy.

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Correspondence to Robert M. Sargis.

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Sabina Shaikh, Jyotsna S. Jagai, Colette Ashley, and Shuhan Zhou declare that they have no conflict of interest.

Robert M. Sargis reports honoraria from CVS.

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

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This article is part of the Topical Collection on Economics and Policy in Diabetes

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Shaikh, S., Jagai, J.S., Ashley, C. et al. Underutilized and Under Threat: Environmental Policy as a Tool to Address Diabetes Risk. Curr Diab Rep 18, 25 (2018). https://doi.org/10.1007/s11892-018-0993-5

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Keywords

  • Diabetes
  • Pollution
  • Toxicant
  • Endocrine-disrupting chemical
  • Environmental policy
  • Environmental justice