The Impact of Climate Change on People Living with Diabetes: A Scoping Review

Objective: There is substantial literature detailing the interaction between climate change and diabetes incidence, prevalence, and development. However, there is limited understanding on the impact of climate change on People Living with Diabetes (PWD). This scoping review describes the impact of climate change on morbidity and mortality for PWD.Materials and methods: The scoping review was conducted between November 2022 and February 2023, using articles published in PubMed Central and Google Scholar databases. Articles published from 1970 to 2022 with the following key terms “diabetes”, “type 1 diabetes”, “type 2 diabetes”, “climate change”, “global warming”, and “natural disaster” were reviewed. Results: A total of 13,838 articles were identified and reviewed. After applying the review criteria, 42 applicable articles were included in the scoping review. PWD are impacted directly by climate change-induced events including extreme temperatures, air pollution, and natural disasters. Difficulty in storing insulin, maintaining special diets, and accessing diabetes supplies are indirect results of the climate crisis on people with diabetes leading to adverse outcomessuch as increased risk of hospitalizations, morbidity, and mortality. Conclusions: Environmental hazards due to climate change increase morbidity and mortality for PWD. Policies that address the interconnection between the two phenomena would improve global diabetes population health. Future research should explore potential solutions to addressing this crisis across multiple populations and settings

Differences in COVID-19 Outcomes Among Patients With Type 1 Diabetes: First vs Later Surges

Background Outcomes of the novel coronavirus SARS-CoV-2 (COVID-19) have improved throughout the pandemic. However, whether outcomes of COVID-19 in the type 1 diabetes (T1D) population improved over time is unknown. Therefore, we aim to investigate differences in COVID-19 outcomes for patients with T1D in the US. Method We analyzed data collected via a registry of patients with T1D and COVID-19 from 56 sites between April 2020 and January 2021. First, we grouped cases into First Surge (04/09/2020 - 07/31/2020, n=188) and Late Surge (08/01/2020 - 01/31/2021, n=410). Then, we compared outcomes between both groups using descriptive statistics and logistic regression models. Results Adverse outcomes were more frequent during the first surge including Diabetic Ketoacidosis (32% versus 15%, p<0.001), severe hypoglycemia (4% versus 1%, p=0.04) and hospitalization (52% versus 22%, p<0.001). The First surge cases were older (28 +/- 18.8 years versus 18.8 +/- 11.1 years, p<0.001), had higher hemoglobin A1c (HbA1c) levels (Median (IQR): 9.3 (4.0) versus 8.4(2.8), <0.001) and use public insurance (n(%): 107 (57) versus 154 (38), p <0.001). There were five times increased odds of hospitalization for adults (OR 5.01 (2.11,12.63) in the first surge compared to the late surge. Conclusion COVID-19 cases among patients with T1D reported during the first surge had a higher proportion of adverse outcomes than those presented in a later surge

Health equity in endocrinology.

Health equity is achieved when every person can achieve their full potential for health and wellbeing. In this Viewpoint, experts from around the world discuss the root causes and contributing factors to health inequity in endocrinology, as well as discuss potential action points and research directions to help reduce health disparities

Health equity in endocrinology

Health equity is when every person can achieve their full potential for health and wellbeing. In this Viewpoint, global experts discuss the root causes and contributing factors to health inequity in endocrinology. Potential action points and research directions to help reduce health disparities are also discussed.</p