Ambient particulate air pollution is associated with higher risk of microvascular complications and diabetic ketoacidosis among persons with type 1 diabetes mellitus in an observational survival study
Authors' conclusion
We hypothesize these effects stem from PM2.5-induced oxidative stress and systemic inflammation, which may exacerbate metabolic disruptions already present in hyperglycemic individuals. Clients and providers may want to consider environmental factors, like air pollution, in T1D management.
Study context
- Population
- Utah persons with T1D
- Participants
- 12, 925 persons
- Exposure
- Higher vs lower ambient PM2.5 exposure
- Outcome
- DKA and kidney, ophthalmic and neurological complications
Methodological detailsobservational survival study, competing-risk Cox proportional hazards regression
- Observational survival study
- Competing-risk Cox proportional hazards regression
Main finding
As reported in the abstract
Risk per IQR increase in one-year PM2.5 exposure
Increased risk of diabetic ketoacidosis (DKA)
28.8 %
95% CI 14.3, 45.2
Increased risk of ophthalmic complications
33.5 %
95% CI 10.0, 62.0
Increased risk of neurological complications
35.1 %
95% CI 14.3, 59.6
Observational data: associations, not effects.
Further findings
DKA with acute PM2.5 exposure (30, 60 and 90 days)
- Acute exposures also associated with increased risk of DKA, although less than one-year exposure
Original publication
Ambient particulate air pollution is associated with higher risk of microvascular complications and diabetic ketoacidosis among persons with type 1 diabetes mellitus in an observational survival study. Diabetes Res Clin Pract. Published 1 November 2025. doi:10.
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