Environmental and Lifestyle Determinants of Type 2 Diabetes Mellitus

Abstract

Objective: This study aims to comprehensively investigate the role of various environmental and lifestyle factors—including obesity, diet, physical inactivity, urbanization, socioeconomic status, sleep patterns, stress, environmental pollutants, gut microbiota, smoking, and alcohol consumption—in the pathogenesis of Type 2 diabetes mellitus (T2DM). Background: Type 2 diabetes mellitus (T2DM) is a global health challenge influenced by genetics, environment, and lifestyle. Key factors affecting T2DM include obesity, unhealthy diet, physical inactivity, urbanization, socioeconomic status, sleep patterns, stress, environmental pollutants, gut microbiota, smoking, and alcohol consumption. Understanding these factors' roles in insulin resistance, beta-cell dysfunction, glucotoxicity, lipotoxicity, and inflammation is crucial for effective prevention and management. Methods: A comprehensive search of databases such as PubMed, MEDLINE, Google Scholar, and various journals was conducted without date restrictions. The studies were systematically reviewed to explore the mechanistic links between environmental factors and T2DM pathophysiology. The study adhered to PRISMA guidelines. Results: The study revealed diverse associations between environmental and lifestyle factors and T2DM pathogenesis. Obesity was identified as a central contributor, promoting insulin resistance and adipose tissue dysfunction. Unhealthy diets increased T2DM risk through glucotoxicity and lipotoxicity. Sedentary behavior and urbanization compounded these effects. Socioeconomic disparities influenced T2DM prevalence, with lower SES individuals at higher risk. Sleep patterns, stress, environmental pollutants, and gut microbiota composition significantly affected T2DM development. Smoking and alcohol consumption were linked to increased insulin resistance and beta-cell dysfunction. These findings highlight the multifactorial nature of T2DM and the importance of addressing diverse environmental and lifestyle factors for effective prevention and management strategies. Conclusion: Obesity, diet, physical inactivity, urbanization, socioeconomic status, sleep patterns, stress, environmental pollutants, gut microbiota, smoking, and alcohol consumption collectively influence insulin resistance, beta-cell dysfunction, glucotoxicity, lipotoxicity, and inflammation in T2DM. Addressing these factors is essential for prevention and management. Promoting healthy lifestyles, improving healthcare access, and mitigating environmental exposures can reduce risk and improve outcomes. Understanding the interplay of these factors provides insights into T2DM's complex nature and informs comprehensive strategies for its prevention and treatment.