Long-term exposure to ambient air pollution and risk of microvascular complications among patients with type 2 diabetes: a prospective study.

This article focuses on the association between long-term exposure to ambient air pollution and the risk of microvascular complications among patients with type 2 diabetes (T2D). In a prospective study of 17,995 UK Biobank participants with T2D free of vascular complications at baseline, increased exposure to particulate matter with diameters <2.5 μm (PM2.5) and <10 μm (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx) was linked to a higher risk of diabetic microvascular complications—specifically nephropathy and neuropathy, but not retinopathy. These associations persisted even at pollutant concentrations below World Health Organization guideline levels, with PM2.5 identified as the main contributor to risk in multi-pollutant analyses. The study found no significant interaction between air pollution exposure and metabolic risk factor control on complication risk, underscoring the potential public health importance of reducing air pollution exposure to prevent microvascular complications in patients with T2D.