Reassessment of the Association Between Airborne PM2.5 and Type 2 Diabetes Mellitus Based on Cohort Studies and Systematic Review

Abstract

Global urbanization and increasing energy consumption have caused widespread PM₂.₅ pollution. Accumulating evidence indicates long-term PM₂.₅ exposure correlates with elevated type 2 diabetes mellitus (T2DM) risk. This study was conducted based on prospective cohort designs, with a systematic literature search performed in PubMed, EMBASE, Web of Science, and other major academic databases. By integrating high-quality published evidence and rigorously minimizing biases from residual confounding, reverse causality, and exposure measurement error, this study systematically evaluates the causal effect of PM₂.₅ exposure on T2DM. The results confirmed a significant causal relationship between long-term PM₂.₅ exposure and elevated prevalence and mortality of T2DM. Populations susceptible to diabetes are recommended to take targeted measures to reduce air pollution exposure. This study carries important theoretical and practical implications for the integrated prevention and control of chronic diseases, and provides robust scientific evidence for developing public health strategies to mitigate air pollution-related health risks and reduce the incidence of T2DM.