Diabetes and the Exposome: Bridging Knowledge Gaps for Improved Health
The diabetes challenge
Worldwide, over half a billion people live with diabetes and this is expected to increase by 46% by 2045. This increase equates to around 1 in 8 adults predicted to be living with the disease. Even more alarming is that a high number of people live with the disease without even knowing it. This was the scene set at the latest LongITools policy forum by Elisabeth Dupont, International Diabetes Federation (IDF) Europe Regional Manager. IDF Europe is an umbrella organisation representing both people living with diabetes and healthcare professionals across 73 national diabetes organisations in 46 countries across Europe.
Several risk factors for type 2 diabetes are non-modifiable such as age, family history and ethnicity, but often people delay or skip their medical appointments due to the stigma surrounding the disease and the misconception that it is self-inflicted. This increases the risk of life altering complications and worse health outcomes.
Understanding and addressing risk
Joline Beulens, a Professor of Epidemiology at Amsterdam University Medical Centers, explained that although lifestyle is an important factor in type 2 diabetes, so much about the effect of the environment on the disease is unknown. Her research has included studying environmental exposures in different living environments, the effect of food environments and access to green space, as well as the social environment, on the risk of type 2 diabetes. Both air pollution and residential noise were shown to be associated with a higher risk, while access to green space is associated with lower risks.
Family walking in a city park
Professor Inga Prokopenko from the University of Surrey, a partner in the LongITools project, presented her latest research which showed for the first time that high blood sugar levels in type 2 diabetes can directly cause lung disorders. This research was the largest-ever study into the genetic basis of random ‘round-the-clock’ blood sugar levels. She highlighted that healthcare professionals should be alert to lung disorders as a potential complication of type 2 diabetes, alongside kidney disease, heart attack and stroke.
The final presentation of the forum was by Professor Timo Lakka from University of Eastern Finland and focused on the Stop Diabetes project. This randomised controlled trial was set up to create and implement evidence-based and digitally supported type 2 diabetes prevention strategies in healthcare and at the population level. A digital tool was developed to support the identification of individuals at increased risk whilst also providing motivation for individuals at increased risk to improve their lifestyles. One key outcome showed that using digital applications daily appears to show the most beneficial changes in risk factors for type 2 diabetes. However, combinations of digital and face-to-face interventions are likely to be more effective than digital interventions alone.
The way forward
The discussion that followed focused on the lack of understanding of diabetes, even amongst those with a medical background, on prevention and research which addresses causality.
In summary, we know that lifestyle and our living environments are associated with the risk of diabetes, but more research is needed to show how the different exposures (the exposome) work collectively to impact our health.
“With the right policies, prevention and risk-reduction programmes, including access to the appropriate tools and technologies, people with diabetes can lead long, healthy and fulfilling lives.”
LongITools hopes to be able to provide a better understanding of the exposome and its impact on the risk of developing type 2 diabetes, as well as obesity and cardiovascular diseases. Through our research and by developing new methodologies and tools, we hope that we can inform current policies and future policy development to help improve the health of European citizens.
A recording of the forum is below.
Future LongITools events
The LongITools policy forums are run every six months and the next event will be held on Thursday 28th September 2023. Please contact us to register your interest for this or future events.