HEALTH CONSEQUENCES OF URBANIZATION: EFFECTS OF AIR AND ELECTROMAGNETIC POLLUTION ON THE PREVALENCE OF OBESITY, DIABETIC COMPLICATIONS AND OLFACTORY DYSFUCTION IN DIABETIC PATIENTS.

Introduction The health consequences of increasing urbanization are calling for clinicians’ attention. Both air and electromagnetic (EM) pollution have been associated to type 2 diabetes mellitus (T2DM). This study aims to evaluate the effects of such pollutants on the prevalence of obesity, T2DM complications and olfactory dysfunction (OD) in two groups of T2DM patients living in different areas of the Lombardy region of Italy with different pollution exposure. Materials and Methods Two comparable groups of T2DM patients coming from an area characterized by a higher level of air and EM pollution in the past 10 years (Milan) and one with a lower level of pollution (Sondrio) were analyzed. Each patient underwent standard diabetology evaluation, ENT exam, psychophysical olfactory testing and filled in a questionnaire on olfactory-related quality of life (QoL). Statistical analysis used non-parametric tests and logistic regression. Results The prevalence of diabetic complications (48.5% vs.25%, p=0.007) and of OD (60.3% vs. 41.2%, p=0.039) was significantly higher in patients from Milan than from Sondrio, while no significant difference was found for obesity (p=0.716). The group with a greater prevalence of OD also reported worse olfactory-related QoL. Regression analysis showed a significant association between OD and the presence of diabetic complications (OR: 3.021; CI: 1.302 – 7.255; p=0.011) and between complications and T2DM duration (OR: 1.186; CI: 1.095 – 1.301; p<0.001). Pollution exposure was a weak independent predictor for both OD and complications in T2DM patients. Conclusions Our study showed that T2DM patients subject to a higher exposure to pollution were more frequently affected by diabetic complications and OD and reported a poorer olfactory-related QoL compared to patients with a lower exposure. We were also able to highlight a strong association between OD and T2DM complications and gathered evidence to support the hypothesis that pollution exposure is associated both with OD and complications in T2DM patients.