Common Chemicals Increasingly Linked to Diabetes
It is common knowledge that diabetes development can be promoted by genetic predisposition as well as environmental triggers. There are many putative environmental influences, and an emerging one is exposure to chemicals known as phthalates.
What Are Phthalates?
“Phthalates are chemicals added to plastics to increase their flexibility, transparency, durability, and longevity,” researchers summarize. Because these chemicals can be found in so many common products, they can make their way into our system via diet, cosmetics use, etc.
A literature review explains that these chemicals have been associated with a higher risk for developing numerous health conditions. Phthalates may disrupt numerous physiological processes, affect endocrine and reproductive functions, and have been associated with diseases like cancers and diabetes.
Phthalates and Diabetes Risk
Several studies address the role of phthalates in diabetes development, including type 1 diabetes, type 2 diabetes, and gestational diabetes.
Numerous research studies indicate that phthalates may increase insulin resistance and potentiate the development of pre-diabetes and type 2 diabetes. A systematic review and meta-analysis published this month concluded that the “findings revealed a positive association between exposure to phthalate metabolites and increased [insulin resistance].”
A population-based study published last year indicated that “increased concentrations of all measured phthalate metabolites were associated with reduced blood glucose control,” and that “exposure to phthalates may possibly impair control of blood glucose and thereby predispose to pre-diabetes.”
Another 2018 study focused on analyzing phthalate metabolites in the context of type 1 diabetes found that “there was a trend for higher levels of metabolites in children with new-onset diabetes.” The researchers also noted that:
There seems to be a relationship between exposure to phthalates and the occurrence of metabolic dysfunctions, such as a decrease in glucose tolerance, oxidative stress, loss of beta cells, and a decrease in insulin synthesis.
It appears that phthalate exposure may also affect gestational diabetes risk. A study published this year also identified an association between phthalate metabolites and gestational diabetes risk. The researchers concluded that:
Additional phthalate metabolites were also found to be linked to glucose intolerance, with possible stronger associations in certain racial/ethnic subgroups. Given the prevalence of phthalate exposures and the growing evidence of associations with metabolic outcomes, future studies should continue to examine this question in diverse cohorts of pregnant women, particularly in those who may be at higher risk for gestational diabetes and impaired glucose tolerance.
In summary, it appears that more and more studies are finding a connection between phthalate exposure and diabetes risk. The increased interest in the subject is highlighted by the number of recent publications and a unanimous call for more investigation on the matter.
It is well-established that phthalates have the potential to negatively affect our health, although all the specific molecular mechanisms and hazards are still in the process of being uncovered.
How do we mitigate our exposure to these chemicals? A recent review discussed that “sources that may be targeted for exposure reduction messaging remain elusive.”
To help identify the risk factors, these researchers performed an analysis to investigate common food sources for the presence of phthalates and found that numerous foods are contaminated. They found that while the phthalate levels in water, beverages, produce and grain products were relatively low, dairy, fats and certain meats (poultry in particular) often tested positive for phthalates at higher concentrations.
An intervention study demonstrated that preparing meals “without any plastics in procurement, cooking, and serving” may help reduce exposure. However, more research is still needed to identify all the major sources of exposure and to develop effective strategies to minimize phthalate intake. Additional investigations will strive to provide the knowledge to help form the most appropriate framework for interventions to reduce the risk.
Castro-Correia C, Correia-Sa L, Norberto S, Delerue-Matos C, Domingues V, Costa-Santos C, Fintoura M, Calhau C; “Phthalates and type 1 diabetes: is there any link?” (2018) Environmental Science and Pollution Research 25(18): 17915-17919. https://link.springer.com/article/10.1007/s11356-018-1997-z
Dales RE, Kauri LM, Cakmak S; “The associations between phthalate exposure and insulin resistance, beta cell function and blood glucose control in a population-based sample” (2018) Science of The Total Environment 612: 1287-1292. https://www.sciencedirect.com/science/article/pii/S0048969717323513
Everett CJ, Medunjanin D, Frithsen IL; “Roles of Environmental Pollution and Pesticides in Diabetes and Obesity” (2018) Nutritional and Therapeutic Interventions for Diabetes and Metabolic Syndrome (5): 53.64. https://www.sciencedirect.com/science/article/pii/B9780128120194000052
Meeker JD, Sathyanarayana S, Swan SH; “Phthalates and other additives in plastics: human exposure and associated health outcomes” (2009) Philosophical Transactions of the Royal Society B: Biological Sciences 364(1526): 2097-2113. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873014/
Serrano SE, Braun J, Trasende L, Dills R, Sathyanarayana S; “Phthalates and diet: a review of the food monitoring and epidemiology data” (2014) Environmental Health 13: 43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050989/
Shaffer RM, Ferguson KK, Sheppard L, James-Todd T, Butts S, Chandrasekaran S, Swan SH, Barrett ES, Nguyen R, Bush N, McElrath TF, Sathyanarayana S, TIDES Study team; (2019) “Maternal urinary phthalate metabolites in relation to gestational diabetes and glucose intolerance during pregnancy” Environmental International 123: 588-596. https://www.ncbi.nlm.nih.gov/pubmed/30622083
Shoshtari-Yeganeh B, Zarean M, Mansourian M, Riahi R, Poursafa P, Teiri H, Rafiei N, Dehdashti B, Kelishadi R; “Systematic review and meta-analysis on the association between phthalates exposure and insulin resistance” (2019) Environmental Science and Pollution Research 1-8. https://link.springer.com/article/10.1007/s11356-019-04373-1#citeas
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