School of Medicine
38 Examining the Temporal Relationship Between Air Quality Trends and Glycemic Outcomes Among Patients with Type 2 Diabetes Mellitus
Catherine Petersen (University of Utah); Ramkiran Gouripeddi (Biomedical Informatics, University of Utah); Sejal Mistry (University of Utah); and Julio C. Facelli (University of Utah)
Faculty Mentor: Ramkiran Gouripeddi (Biomedical Informatics, University of Utah)
Abstract
Type 2 diabetes mellitus (T2DM) is a chronic condition caused by insulin resistance and metabolic dysfunction. Approximately 37 million individuals in the United States have T2DM.6 Long term exposure to air pollution is thought to increase insulin resistance and impair glucose metabolism due to oxidative stress and inflammation.4 Particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5), more specifically its ultrafine component, can cross the pulmonary alveolar membrane and direct inflammatory effects on target organs.4 While several studies have identified a relationship between PM2.5 concentrations and onset of T2DM1,2,4, few studies have examined the role of air pollution on glycemic outcomes after T2DM diagnosis. There is a possibility of air pollution worsening glycemic control and metabolic dysfunction and contribute to poor glycemic outcomes. Therefore, the objective of this research was to evaluate the relationship between temporal trends in PM2.5 concentrations and glycemic outcomes among patients with T2DM in Davis, Utah, and Salt Lake Counties in Utah. Electronic medical record data from EPIC for 143,434 patients with an eligible ICD-10 diagnosis code for T2DM from 2010-2022 were selected for analysis. PM2.5 concentrations were extracted from the EPA’s Air Quality System in Davis, Utah, and Salt Lake counties in Utah. The date of a patient’s initial diagnosis was found and visually assessed with one-year trends in PM2.5 concentrations. Analysis is ongoing and it is hopeful that the results of this study will elucidate the role of PM2.5 concentrations on glycemic outcomes in patients with T2DM and may inform public health interventions to minimize air pollution and encourage better outcomes for individuals with T2DM.
Introduction
Type 2 diabetes mellitus (T2DM) is a chronic condition caused by insulin resistance and metabolic dysfunction4. Diabetes affects roughly 37 million people, with T2DM accounting for roughly 90-95% of diabetes prevelence6. T2DM is associated with many diabetes-related complications, including heart disease, vision loss, and kidney disease.7
The potential risk factor of interest for this study is exposure to air pollution. As illustrated in Figure 1, the ultrafine component of particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5), can cross the pulmonary alveolar membrane and is thought to increase insulin resistance and impair glucose metabolism due to oxidative stress and inflammation on target organs.3 Although several past studies have identified a relationship between PM2.