Climate Change and Ambient Temperature Extremes: Association With Serious Hypoglycemia, Diabetic Ketoacidosis, and Sudden Cardiac Arrest/Ventricular Arrhythmia in People With Type 2 Diabetes

Pressures of the urban environment on the endocrine system: Adverse effects and adaptation

With an increasing collective awareness of the rapid environmental changes, questions and theories regarding the adaptability of organisms are emerging. Global warming as well as chemical and non-chemical pollution have been identified as triggers of these adaptative changes, but can we link different kinds of stressors to certain phenotypic traits? The physiological adaptation, and particularly endocrine system adaptation, of living beings to urban environments is a fascinating way of studying urban endocrinology, which has emerged as a research field in 2007. In this paper, we stress how endocrine disruption in humans and environment can be studied in the urban environment by measuring the levels of pollution, endocrine activities or adversity. We broaden the focus to include not only exposure to the chemicals that have invaded our private spheres and their effects on wild and domestic species but also non-chemical effectors such as light, noise and climate change. We argue that taking into account the various urban stress factors and their effects on the endocrine system would enable the adoption of new approaches to protect living organisms.

The impact of daily mean air temperature on the proportion of time in hypoglycemia in 2,582 children and adolescents with type 1 diabetes - Is this association clinically relevant?

OBJECTIVES

To study the potential association between increases in daily mean air temperature and time below range (TBR <54 mg/dl) and time above range (TAR >250 mg/dl) in children and adolescents with type 1 diabetes.

RESEARCH DESIGN AND METHODS

Individuals with type 1 diabetes <21 years with information on daily glucose profiles from the diabetes prospective follow-up study (DPV) were included (n = 2582). Further inclusion criteria were age at least 6 months at diabetes onset, diabetes duration for at least one year and treatment years 2020-2021. Mean daily air temperature and other meteorological parameters from 78 measurement stations in Germany were linked to the individual glucose sensor profile via the five-digit postcode areas of residency. We used multivariable repeated measures fractional logistic regression models with a compound symmetry covariance structure to study the association between a 1 °C increase in daily mean temperature and time in specific glucose ranges.

RESULTS

A 1 °C increase in daily mean temperature was associated with an acute (Odds Ratio (OR) 1.009 (95%-CI 1.007, 1.011)) and up to 7 days delayed (OR 1.003 (1.001, 1.005)) increase in TBR <54 mg/dl. Moreover, an acute decrease in TAR >250 mg/dl (OR 0.997 (0.996, 0.997)) was found.

CONCLUSIONS

Results of the DPV registry showed small, but statistically significant changes in TBR and TAR in association with a short-term temperature increase. Higher blood flow and faster insulin absorption might be one possible mechanism. In times of increasing temperature fluctuations meteorological impacts on time in range could become even more relevant.

Incidence of diabetic ketoacidosis does not differ in Ramadan compared to other months and seasons: results from a 6-year multicenter study

BACKGROUND

Diabetic ketoacidosis (DKA) is a life-threatening adverse complication of patients with diabetes mellitus (DM). It is postulated that fasting during Ramadan can increase the risk of DKA; however, there are contradicting data in this regard. Furthermore, studies from Western countries have suggested a seasonal variation in the incidence of DKA. This study examines the differences in the number of DKA episodes during Ramadan compared to the rest of the year in patients with type 1 DM (T1D) and type 2 DM (T2D). Besides, we aim to examine the seasonal difference in the incidence of DKA.

METHODS

We included consecutive index-DKA admissions from 2015 to 2021 and used descriptive statistics to compare the episodes of DKA in Ramadan vs other months and seasons.

RESULTS

Of 922 patients, 480 (52%) had T1D, whereas 442 (48%) had T2D. The median age (IQR) was 35 (25-45) years, with the majority being Arab (N = 502, 54.4%). There were 94 DKA admissions in six collective Ramadan months, whereas the DKA admissions ranged from 61 to 88 episodes in other months (p = .3). The highest DKA admissions were observed in Autumn (N = 236) and the lowest in Spring (N = 226) with no statistically significant difference (p = .4). There were no differences in DKA severity or new-onset diabetes rates when analyzed based on Hiji months, Roman months, or seasons.

CONCLUSIONS

DKA occurrence is not increased during Ramadan. We found no evidence of seasonal variations in the rates of DKA in the State of Qatar.

Geospatial techniques for monitoring and mitigating climate change and its effects on human health

This article begins by briefly examining the multitude of ways in which climate and climate change affect human health and wellbeing. It then proceeds to present a quick overview of how geospatial data, methods and tools are playing key roles in the measurement, analysis and modelling of climate change and its effects on human health. Geospatial techniques are proving indispensable for making more accurate assessments and estimates, predicting future trends more reliably, and devising more optimised climate change adaptation and mitigation plans.