Beyond Diabetes - The Role of Toxins in the Development of Type 2 Diabetes

Chelsea Azarcon
BSc, ND
https://www.auburnnaturopathicmedicine.com
5 May 2020

Language English

Diabetes is a common condition of the modern world with rates of prevalence on the rise. The International Diabetes Federation estimates that in 2019, 463 million adults currently had diabetes, with a projection for this to increase to 700 million people in the next 25 years. (1) For Canadian adults, Diabetes is the number one cause of blindness, end-stage renal disease, and amputations unrelated to trauma. (2) While there are two types of Diabetes, Type 1 and 2, Type 2 Diabetes is the most common. (3) Type 2 Diabetes is a condition characterized by inability to adequately make or respond to insulin. Insulin is a hormone, produced by your pancreas, that helps move sugar from your bloodstream into your cells, where it can be used to make energy. Deficiencies or resistance to insulin lead to elevated levels of blood sugar.

Excess sugar in the bloodstream creates widespread damage. Over time, it leads to the complications of Type 2 Diabetes which include increased risk of cardiovascular disease, kidney disease, Alzheimer’s disease, blindness, nerve damage and sensory loss in limbs, limb amputation, depression, and even early death. (4) Unlike Type 1 Diabetes which often appears in childhood and has a strong hereditary component, Type 2 Diabetes usually occurs later in life with strong lifestyle risk factors, in addition to a genetic component. Because many of the identified risks are related to lifestyle, there is impressive potential for prevention. Examples of modifiable risk factors are low exercise, being overweight, and having high blood pressure and blood cholesterol.

While Type 2 Diabetes is conventionally managed with prescription medications, naturopathic care seeks to adjunctively or alternatively address preventable risk factors and reduce blood glucose using researched natural products. However, a contributor to Diabetes little discussed in conventional or naturopathic medicine is the role of environmental toxins. This is a relationship that is beginning to become clear, linking Type 2 Diabetes to Persistent Organic Pollutants, Arsenic, BPA, Phthalates, Polyaromatic Hydrocarbons, and PCB’s.

Persistent Organic Pollutants- is your dinner giving you Diabetes?

Persistent Organic Pollutants (POPs) are chemicals that remain in the environment for long periods of time, and have negative effects on human health.(5) A common way that humans are exposed to POPs is through diet, especially consumption of high fat animal products like meat, milk, and eggs.(6) Several researchers have demonstrated a relationship between the levels of POPs found in blood with Type 2 Diabetes: as the amount of POPs in blood increased, so did Diabetes prevalence.(7) The more POPs present in the blood, the greater the risk for Diabetes.(8) Most shockingly, when POPs were low enough, one of the most commonly known risk factors for Type 2 Diabetes (being overweight) was eliminated.(9) Additionally, POPs can independently increase risk for obesity. (10) Although diet can be a source of POP exposure, eating organic has shown to decrease blood levels of certain types of POPs in only 3 days! (11)

Arsenic- your chicken is hijacking your pancreas

Arsenic is an elemental metal that humans can be exposed to through diet. Toxic forms can be found in rice, chicken, certain herbal supplements, and ground water. It has also been historically used as a pesticide. Arsenic can promote Diabetes through its effects on the pancreas. In a state of health, your pancreas secretes insulin in response to elevated levels of sugar in the blood. Arsenic blocks this process by blunting the secretion of insulin. The amount of arsenic found in both toenails and urine has been correlated to higher levels of Diabetes prevalence.(12) In people with urinary arsenic above a certain threshold, the risk of diabetes doubles.(13)

BPA & Phthalates- Diabetes comes canned

BPA stands for Bisphenol A, a synthetic chemical used to make plastics soft and flexible. Like BPA, phthalates are also chemicals used as plasticizers. Humans are exposed to BPA through food packaging such as plastic water bottles and cans. Even BPA free packaging can present potential problems, since BPA is simply swapped out for other bisphenols with similar actions to BPA. Phthalates can be found in cosmetic products and vinyl. Thus, phthalates can be found in everything from your shower curtain to your shampoo. In humans with increased levels of urinary BPA, increased prevalence of Diabetes has been observed.(14) Adults exposed to BPA levels above a disease causing threshold, increase their risk of Diabetes by almost 1.5 times. In humans with increased levels of urinary phthalates, an increased risk of Diabetes was observed by almost 25 times.(15)

Polyaromatic Hydrocarbons- Diabetes on the barbecue

Polyaromatic Hydrocarbons (PAHs) are chemicals used in production processes. They are components of things like paints, gasoline, cigarettes, styrofoam, rubber, and are produced when food is barbecued. People living in cities have an especially high exposure burden. A handful of PAHs have been found to increase likelihood of Type 2 Diabetes by 78-124%. This risk is complemented by the fact that some PAHs increase independent risks of diabetes such as obesity and elevated blood pressure and blood lipids.(16)

PCB’s- there’s more to your receipt

PCB stands for polychlorinated biphenyl, a chemical that is found in a wide variety of environmental exposures. Like POPs it can be ingested in animal products: farmed fish, eggs, milk, and meat. Like BPA, it can be found in plastics. Routine exposure to PCB’s can also be obtained through contact with shopping receipts. PCBs have the ability to bind the sites on cells where insulin normally binds, preventing it from effectively performing its job. Studies examining PCB level with Diabetes prevalence have identified a 4 times greater risk of Diabetes in those with the highest levels of PCBs.(17)

Summary

Beyond the Diabetes we know to be associated with metabolic risks such as elevated lipids, blood pressure, and weight, lies the potential for a host of yet unrecognized risks. These associations beg the question: does it matter? POPs, Arsenic, BPA, Phthalates, PAHs, and PCB’s are all ubiquitous. We encounter them in the food we eat, the water we drink, and the fabric of our daily lives. Because of that, considerable percentages of adults studied presented levels of these chemicals above the threshold that has been identified to cause disease. For PCB’s, arsenic, and BPA this percentage ranges from 20-28%. For phthalates and certain PAHs this range can be as high as 55-69%.(18) Not only have these chemicals been identified with higher risks of Diabetes, many have been correlated with higher risks of Diabetes risk factors such as obesity and elevated blood lipids. With prevalence of both Diabetes and toxin exposure growing, limitation of exposure and detoxification to these chemicals may provide an important strategy in Diabetes prevention.

References:

^{^[i]} Special thanks to Dr. Jospeh Pizzorno for compiling much of this information in his presentation at Bastyr University California

Facts & figures. (n.d.). Retrieved from https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html

^{^[ii]} Houlden, R. L. (2018). Diabetes Canada Clinical Practice Guidelines Expert Committee: 2018 Clinical Practice Guidelines. Canadian Journal of Diabetes, 42, S1-S5. Retrieved from https://www.canadianjournalofdiabetes.com/article/S1499-2671(17)30811-0/pdf

^{^[iii]} Public Health Agency of Canada. (2019, December 9). Diabetes in Canada. Retrieved from https://www.canada.ca/en/public-health/services/publications/diseases-conditions/diabetes-canada-highlights-chronic-disease-surveillance-system.html

^{^[iv]} Type 2 diabetes - Symptoms and causes. (2019, January 9). Retrieved from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193

^{^[v]} Persistent organic pollutants (POPs). (n.d.). Retrieved from https://www.who.int/foodsafety/areas_work/chemical-risks/pops/en/

^{^[vi]} Cornell, Jennifer. Persistent Organic Pollutants. December 2018. Delivered at Bastyr University, California. Powerpoint Presentation.

^{^[vii]} Lee, D., & Jacobs, D. R. (2006). A Strong Dose-Response Relation Between Serum Concentrations of Persistent Organic Pollutants and Diabetes: Results From the National Health and Nutrition Examination Survey 1999-2002: Response to Porta. Diabetes Care, 29(11), 2568-2568. doi:10.2337/dc06-1720

^{^[viii]} Ukropec, J., Radikova, Z., Huckova, M., Koska, J., Kocan, A., Sebokova, E., … Klimes, I. (2010). High prevalence of prediabetes and diabetes in a population exposed to high levels of an organochlorine cocktail. Diabetologia, 53(5), 899-906. doi:10.1007/s00125-010-1683-2

^{^[ix]} Pizzorno, Joseph. Toxin Avoidance and Effective Detoxification. January 2019. Delivered at Bastyr University, California. Powerpoint Presentation.

^{^[x]} Reaves, D. K., Ginsburg, E., Bang, J. J., & Fleming, J. M. (2015). Persistent organic pollutants and obesity: are they potential mechanisms for breast cancer promotion? Endocrine-Related Cancer, 22(2), R69-R86. doi:10.1530/erc-14-0411

^{^[xi]} Curl, C. L., Fenske, R. A., & Elgethun, K. (2003). Organophosphorus pesticide exposure of urban and suburban preschool children with organic and conventional diets. Environmental Health Perspectives, 111(3), 377-382. doi:10.1289/ehp.5754

^{^[xii]} Pan, W., Seow, W. J., Kile, M. L., Hoffman, E. B., Quamruzzaman, Q., Rahman, M., … Christiani, D. C. (2013). Association of Low to Moderate Levels of Arsenic Exposure With Risk of Type 2 Diabetes in Bangladesh. American Journal of Epidemiology, 178(10), 1563-1570. doi:10.1093/aje/kwt195

^{^[xiii]} Navas-Acien, A. (2008). Arsenic Exposure and Prevalence of Type 2 Diabetes in US Adults. JAMA, 300(7), 814. doi:10.1001/jama.300.7.814

^{^[xiv]} Lang, I. A. (2008). Association of Urinary Bisphenol A Concentration With Medical Disorders and Laboratory Abnormalities in Adults. JAMA, 300(11), 1303. doi:10.1001/jama.300.11.1303

^{^[xv]} Song, Y., Chou, E. L., Baecker, A., You, N. Y., Song, Y., Sun, Q., & Liu, S. (2015). Endocrine-disrupting chemicals, risk of type 2 diabetes, and diabetes-related metabolic traits: A systematic review and meta-analysis. Journal of Diabetes, 8(4), 516-532. doi:10.1111/1753-0407.12325

^{^[xvi]} Ranjbar, M., Rotondi, M. A., Ardern, C. I., & Kuk, J. L. (2015). Urinary Biomarkers of Polycyclic Aromatic Hydrocarbons Are Associated with Cardiometabolic Health Risk. PLOS ONE, 10(9), e0137536. doi:10.1371/journal.pone.0137536

^{^[xvii]} ^{^[xvii]}/Pizzorno, Joseph. Toxin Avoidance and Effective Detoxification. January 2019. Delivered at Bastyr University, California. Powerpoint Presentation.

^{^[xviii]} Pizzorno, Joseph. Toxin Avoidance and Effective Detoxification. January 2019. Delivered at Bastyr University, California. Powerpoint Presentation.

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