9 Unexpected Diabetes Triggers – Dr. Axe
We know that a poor diet and inactivity, two common factors of the Western diet and way of life, can lead to type 2 diabetes. But what’s not discussed very much is how so many people are dealing with this disease for other, lesser-known reasons. Reasons that are sometimes outside of their control.
Have you ever thought about type 2 diabetes as an illness of the environment? In our lifetime, we’re exposed to thousands of chemicals, sometimes on a daily basis. From the BPA found in canned goods to vehicle exhaust and phthalates found in certain plastic, these environmental chemicals may alter your metabolic function in a major way. It may seem confusing, but think about how chemicals around us impact hormone balance and function, including hormones that regulate our metabolism.
According to a cost analysis published in The Lancet in 2016, diseases related to household chemicals cost the United States $340 billion annually, which is about 2.33 percent of the country’s gross domestic product. The economic burden of these endocrine-disrupting chemicals is much higher in the U.S. compared to Europe, which spends $217 billion annually. That’s due to differences in chemical regulations, according to researchers. (1)
So what do these numbers and alarming diabetes rates tell us? There’s something wrong with the regulation of environmental chemicals and it’s affecting our health. Until some serious changes are made to the way we circulate chemicals into our foods and products, being aware of the most serious unexpected diabetes triggers and how to avoid exposure to these chemicals in the future can make a huge impact.
Type 2 Diabetes Triggers: It’s Not All About Food & Exercise
It’s true that type 2 diabetes is caused by a poor diet and lack of exercise, but recent research suggests there’s more to the story. The numbers just aren’t adding up. For instance, the International Federation of Diabetes reports that the global prevalence of diabetes was 415 million people in 2015 and is expected to rapidly increase to 642 million people in 2040. (2) With widespread awareness about diet’s and exercise’s role in type 2 diabetes, why the rapid increase in cases?
This could mean that a diabetic diet plan or more crunches won’t necessarily work for everyone when it comes to lowering the risk of type 2 diabetes. Scientists are increasingly interested in the role of environmental chemicals in the epidemics of both diabetes and obesity. Studies show links between several environmental exposures and type 2 diabetes, plus, evidence to support a “developmental obesogen” hypothesis, which suggests that chemical exposures may even increase the risk of obesity by altering the development of neural circuits that regulate our feeding behavior. (3)
Traditional risk factors for diabetes, such as obesity, lack of physical activity, old age and family history of diabetes, cannot alone explain the rapidly increasing prevalence of this disease. Certain environmental chemicals and heavy metals that contaminate the air, water and soil chronically expose children, adults and women in their prenatal period, amplifying this epidemic. (4)
Research shows that chronic exposure to arsenic can interfere with insulin secretion and increase the risk of developing type 2 diabetes. According to a 2017 study published in the American Journal of Physiology, arsenic “contaminates the drinking water of approximately 100 million people globally and has been associated with insulin resistance and diabetes.” In the study, mice exposed to sub-toxic levels of inorganic arsenic in drinking water for eight weeks exhibited impaired glucose tolerance compared to controls. Researchers also found that arsenic exposure induced alternations in daily food intake patterns and energy metabolism. Scientists concluded that exposure to arsenic impairs glucose tolerance by altering insulin secretion from beta cells that are found in the pancreas and changing behaviors that affect metabolic function. (5)
Arsenic is detected in our water, oil, air and food. Sadly, it’s impossible to avoid arsenic exposure because it’s found naturally in our environment. On top of that, the U.S. Food and Drug Administration doesn’t set limits for total arsenic in our foods, which is why it’s been detected in common foods like rice, chicken, apple juice and protein powder. And besides the arsenic in your rice, it’s still used in a variety ways, like as a feeding additive, as an insecticide, to preserve wood, as a pesticide, in pharmaceuticals and pigments. Until our government puts federal standards in place to reduce the presence of arsenic in our food and environment, you can begin to limit arsenic exposure by eating organic, whole foods and limiting grains. (6)
BPA, or Bisphenol A, is a synthetic compound that’s used to produce certain plastics, canned foods, toys, medical devices and drink liners. Research shows that BPA is associated with a wide variety of health disorders and it has potential endocrine-disrupting and diabetogenic effects. According to a review published in the International Journal of Environmental Research and Public Health, human and lab studies suggest that BPA exposure is linked to an increased risk of developing type 2 diabetes. The synthetic compound acts directly on pancreatic cells and impairs insulin and glucagon secretion, thereby triggering an insulin-resistant state.
Data shows that BPA levels are highest in formula-fed infants using polycarbonate bottles, with estimated intakes of 11 micrograms per kilogram of body weight. It’s estimated that the daily intake for adults is about 1.5 micrograms per kilogram of body weight. Toxic levels of BPA, which can have adverse health effects, is five micrograms per kilogram of body weight per day. And buyer beware: Many products that are labeled BPA-free now contain BPS (bisphenol S) and other chemicals that can also lead to metabolic disorders. To avoid BPA toxic effects, use glass containers and high-quality stainless steel containers whenever possible. (7)
And say no to trivial cash register receipts, which are usually coated with BPA or related compounds.
PCBs (polychlorinated biphenyls) are man-made organic chemicals used in hundreds of industrial and commercial applications. No longer used in commercial products in the U.S., these chemicals tend to linger. (They were officially banned in the U.S. in 1979.) Research suggests that PCBs remain in the human body long after exposure because the toxins accumulate in our fatty tissues. Before the ban, the chemicals were used to make oil-based paint, plastics, floor finish, caulking, thermal insulation material and electrical devices. PCBs are also released into the environment from burning wastes, poorly managed landfills and leaks from electrical transformers. They’re also found in the bodies of small organisms and fish, including the fish we eat. (8)
Bob Weinhold, a member of the Society of Environmental Journalists, examined studies with mice that linked exposures to PCBs to the disruption of several important body functions. PCB exposure was associated with significant impairment of glucose and insulin tolerance; data shows that the results lasted for two weeks after PCB exposure. Researchers also found that PCB exposure significantly increased the concentrations of inflammatory cytokines, which are related to insulin resistance.
The mice used in the study that ate a low-fat diet and exhibited more adverse effects than PCB-exposed mice fed a high-fat diet. Why might this be? The theory is as you lose weight, PCBs stored in your body are released back out into your system. (9)
Because these studies include mice, it’s difficult to translate the findings to understand the impact PCBs have on humans and at what levels PCBs can be considered toxic. To reduce your risk of PCB exposure, especially in schools and buildings that were built before the ban, all PCB fluorescent lights, caulking, paint and other building materials need to be removed and replaced. The Environmental Protection Agency offers a write-up of practical actions that can be taken to reduce exposure to PCBs. It’s worth reading through. (10)
PAHs (polycyclic aromatic hydrocarbons) are a class of chemicals that occur naturally in gasoline, crude oil and coal. They are produced when coal, gas, oil, tobacco and garbage are burned, and they contaminate the air with vehicle exhaust, cigarette smoke, fumes from coal-tar and asphalt driveways, burnt meat and burning wood. According to the National Report on Human Exposure to Environmental Chemicals, of the 2,500 or more participants that were measured for ten different PAH metabolites, most people tested positive for some level of PAH, which indicates that exposure to the chemicals is widespread in the United States. (11)
A 2014 study published in Occupational and Environmental Medicine indicates that high urinary levels of PAHs in participants who were examined from 2001 to 2006 are associated with the development of type 2 diabetes in U.S. adults ranging in ages 20 to 65 years. These results were independent of potential risk factors like gender, race, smoking or BMI. Researchers also noted that previous studies have reported that chronic exposure to PAHs is also linked to oxidative stress and inflammation, which plays a major role in the development of type 2 diabetes. (12)
Two of the primary sources of PAH in the U.S. population is through the inhalation of cigarette smoke and the consumption of PAHs in food. Cooking meat or other foods at high temperatures, including grilling and charring, increases the amount of PAHs in food. To avoid a major grilling mistake that can lead to increased PAH exposure, precook your meat before putting it on the grill in order to reduce the drippings that turn into smoke and cause PAHs.
Phthalates are chemical compounds that are used as plasticizers in order to increase the durability, flexibility and transparency of products made with plastic. A study conducted in Australia investigated the associations between phthalate concentrations in 1,504 and the development of type 2 diabetes and other chronic diseases. Researchers detected phthalates in 99.6 percent of the participant urine samples and they found that total phthalate concentrations were positively associated with type 2 diabetes, as well as cardiovascular disease and hypertension. In addition to these findings, when the researchers adjusted for factors that typically contribute to these health conditions, like alcohol consumption and smoking, the link between phthalates and disease didn’t change. This suggests that phthalate exposure is directly related to the development of type 2 diabetes and heart disease in men between the ages of 39 and 84. (13)
According to the EPA, “Phthalates are used in many industrial and consumer products, many of which pose potentially high exposure.” These chemicals are used in cosmetic products, household cleaning products, packaging material and medical-care products. The best ways to avoid phthalate exposure is to make your own beauty and skin care products at home, use natural cleaning products, avoid consuming foods that are sold in plastic and don’t store foods in plastic and look for DEP-free or “phthalate-free” products. (14)
Research shows that mercury can induce hyperglycemia by altering the function of pancreatic beta cells. According to a systematic review published in Environmental Research evaluated 34 studies that measured the increased risk of type 2 diabetes and metabolic syndrome due to mercury exposure. Although the relationship between exposure to mercury and type 2 diabetes is not consistent across all studies, there’s data that suggests an association between total mercury concentrations and the incidence of diabetes. (15)
One study involving 3,875 American young adults assessed whether toenail mercury levels are associated with diabetes. The participants were first evaluated in 1987 and received six follow-up evaluations until 2005. Over the 18-year period, there was a total of 288 cases of diabetes and researchers found that toenail mercury levels were positively associated with the incidence of diabetes after adjusting for other risk factors such as sex, ethnicity, smoking status, alcohol consumption, physical activity and family history of diabetes. (16)
Mercury, a heavy metal that’s found in the Earth’s crust, is released into the environment because of human activities like gold mining and coal burning. Mercury is also found in dental amalgam fillings, electrical switches, glass thermometers and fluorescent light bulbs. And organic mercury can be found in fish, especially large fish like swordfish, shark, king mackerel, bigeye tuna and tilefish. To reduce your exposure to mercury, avoid mercury poisoning and decrease your risk of developing health conditions as a result of mercury exposure, cut back on eating high-mercury fish, try a heavy metal detox and avoid using herbal medicines that are made outside of the United States, as they have been known to contain toxic levels of mercury.
Like mercury, cadmium is found naturally in the environment and it’s released through smelting and mining. It’s also used in many industrial processes, like metal plating, in stabilizes in plastics and in producing pigments. It also contaminates food that comes from soil or water containing cadmium. Some plants that may contain cadmium include vegetables, rice and other cereal grains, potatoes and tobacco. It can also enter the food chain from water that’s been contaminated from mining operations.
A meta-analysis conducted in 2017 evaluated nine studies with a total of 28,691 participants to determine the association between cadmium and diabetes risk. Researchers found that for every 1 microgram per gram of urinary cadmium, the risk of diabetes increased by 16 percent. It was concluded that cadmium exposure may be significantly associated with the prevalence of diabetes, although larger prospective studies are needed to confirm these findings. (17)
There are agencies, like the EPA and FDA, that have set standards to regulate cadmium exposure. Exposure to cadmium through diet alone is not believed to cause major health effects, but smokers and those who are exposed to higher levels of cadmium because of their occupations are at a greater risk. This includes alloy makers, auto mechanics, battery makers, mining and refinery workers and pesticide makers. There is a full list of occupations that increase the risk of toxic cadmium exposure provided by the Agency for Toxic Substances and Disease Registry. (18)
Pesticides are chemicals that are widely used in agriculture to prevent and destroy pests that hinder the productivity of crops. The universal use of pesticides, which is a term used for a number of chemical structures, causes environmental pollution across the globe and exposure to humans through the food chain. In fact, the environmental contamination of pesticides is the most significant in developing countries because the use of these chemicals is so extensive and poorly managed or restricted. (19)
A systematic review and meta-analysis published in Environment International assessed the role of pesticides in the pathogenesis of diabetes. Researchers included 22 studies in their analysis and found a positive association between increased pesticide exposure and diabetes prevalence. (20)
Research shows that the adverse effects of pesticides can be acute or chronic, depending on your exposure. To reduce your pesticide intake and exposure, make sure to go organic when you’re buying any of the dirty dozen foods. This includes strawberries, apples, cherries, peaches and spinach. Become familiar with the practices of organic farming and how it surpasses conventional farming practices in its benefits and environmental impact.
Nickel is a metal that is often combined with other metals to form alloys that are used in making metal coins, jewelry, valves and heat exchangers. Nickel is also used to make some batteries and color ceramics. The metal is released into the environment from the stacks or large furnaces at power plants or trash incinerators. It can also be released in industrial water waste and end up in soil or sediment.
A study published in the International Journal of Epidemiology investigated the association of nickel exposure with the prevalence of type 2 diabetes among adults in China. Researchers found that the median concentration of urinary nickel among the 2,115 participants was 3.6 milligrams per liter and the prevalence of diabetes was 35 percent. Elevated levels of urinary nickel were positively associated with higher fasting glucose levels and insulin resistance. (21)
People who breathe in dust or fumes containing nickel, such as welders, are at an increased risk of toxic nickel exposure. Those who work with nickel-containing metal and solutions are also at risk. According to the Agency for Toxic Substances and Disease Registry, the amount of nickel found in foods and drinking water does not a pose a threat to your health. (22)
Burning fossil fuels results in a whopping 180,000 metric tons of nickel per year, making burning fossil fuels and industrial processes the top causes of nickel contamination in our air, soil and water. Supporting local, regional and global clean energy is required to turn this trend around.
If solar or wind energy at your home isn’t feasible at this time, you can check into sourcing a power provider that utilizes 100 percent clean energy. You continue to pay your utility company, but a clean energy supplier will work with your utility to make sure the energy you use is replaced on the grid with clean energy. The result is cleaner air for us to breathe and fewer of the proven health impacts related to burning fossil fuels.
- A growing amount of research is pointing to the idea that traditional risk factors for diabetes, such as obesity, lack of physical activity, old age and family history of diabetes, cannot alone explain the rapidly increasing prevalence of this disease.
- Scientific evidence supports the role of environmental chemicals in diabetes. These unexpected diabetes triggers have shown to induce toxic effects on the pancreas, disturb fasting glucose levels and increase insulin resistance.
- The nine unexpected diabetes triggers that have proven to be linked to a higher prevalence of type 2 diabetes include: