Growing burden of diabetes in Pakistan and the possible role of arsenic and pesticides

Abstract

This review is undertaken to address the possible role of arsenic and pesticides in the prevalence of diabetes in Pakistan and to highlight a resourceful targeted research in this area.A bibliographic search of scientific databases was conducted with key words of “epidemics of diabetes in Pakistan”, “diabetes in Asia”, “diabetes mellitus and environmental pollutants”, “diabetes mellitus and heavy metals”, “diabetes mellitus and pesticides”, “prevalence of pesticides in Pakistan”, and “heavy metals contamination of drinking water, “vegetables and fruits in Pakistan”. More than 200 articles were examined. Studies reporting the prevalence of diabetes mellitus (DM), pesticides and heavy metal contamination of drinking water, fruits and vegetables were included in the study. According to WHO 2011 report, about 12.9 million people are suffering from DM and the number is constantly increasing. Water pollution is a major public health threat in Pakistan. Most of the people in Pakistan are exposed to arsenic and pesticides either in drinking water or through vegetables, fruits, and other edible items with various concentrations above the WHO/FAO permissible limits. Being an agricultural country, a 1169% increase has been recorded with the use of different types of pesticides since last two decades, and almost similar rise in the burden of diabetes.There is a growing global concern of arsenic and pesticides exposure with the incidence of DM. Besides other factors, the environmental attributors in the incidence of DM in Pakistan have not been conclusively elucidated yet which in turn deserve a resourceful targeted research.

Environmental determinants of aplastic anemia in Pakistan: a case-control study

“…Arsenic exposure caused by soil and ground water contamination has remained a serious health concern for populations globally and has been related to various cancers and genetic and metabolic dysfunctions in humans (Shankar et al 2014 ). The situation is a major public health concern in Pakistan as well, where contamination of drinking water in affected areas exceeds the WHO permissible limits (Bahadar et al 2014 ; Rahman et al 2009 ). Although we found this to be significantly associated with AA disease occurrence in the univariate analysis, after careful adjustment with important covariates, the significance of an association between arsenic exposure and AA eventually diminished.…”

The Pro115Gln Missense Mutation of Peroxisome Proliferator Activated Receptor γ (PPARγ) Gene in Diabetes in the Pakistani Population

“…According to a report published by world health organization (WHO) in 2011, the trend of diabetes in Pakistan is also increasing with the passage of time (20). Missense mutation Pro115Gln and Ser114 constitute negative effects on activity of protein and cause insulin resistance.…”

Is Insulin Resistance Work Related?

“…Heavy metals: Numerous studies indicated an association between heavy metals and insulin resistance (cardio-vascular diseases and diabetes) [122][123][124][125][126][127] explained by their direct effects on ROS production and inflammatory mediated cellular and systemic damage, decreased mitochondrial function with reduction of the capacity for fatty acid oxidation, inhibition of lipoprotein lipase in adipocytes and β-cells destruction [128]. Maternal gestational diabetes is also increased by heavy metal exposure [129].…”