Impact of Climate Change on Metabolic Disorders

Mitigation measures and key take home messages.

The possible mitigation measures for climate change effects on metabolic disorders can be envisaged by considering the upstream determinants of diseases such as diabetes:

Mitigation measures could include:

Ø Increased walkability and active travel. More distances walked and cycled by individuals, and reduced air pollution levels could be achieved with well planned urban environments, through transport policies and urban design.

Ø Food policies that encourage shifting the diet from a highly processed and animal-based diet to a ‘sustainable diet’ that offers low environmental impacts, delivers food and nutrition security, and supports a healthy lifestyle for present and future generations. To ensure sustainable diets, sustainable food systems coupled with sustainable agriculture are required.

Ø At national level, a multisectoral approach will be needed to develop a strategy for geo-environmental diabetes management. In regions at risk for geological or extreme weather events there is a need for coordinated efforts of the government, NGOs, and healthcare institutions to:

1. Develop, implement, and disseminate preparedness plans with targeted information for diabetes patients;

2. Develop contingency planning for emergency transport of the most susceptible patients and actions in case of potential barriers to accessing care;

3. Anticipate the quantity of supplies and medications for patients;

4. Mitigate disparities in diabetes disaster preparedness.

Ø At healthcare provider level, GPs should:

1. Identify T2D patients with cardiovascular complication or chronic kidney disease, who may require a certain individualized management plan;

2. Routinely conduct pre-summer medical assessment and counselling relevant to heat exposure for people with diabetes;

3. Be aware of the potential side effects of the medicines prescribed and adjusting dosage if necessary;

4. Conduct more frequent monitoring and check-ups during extreme weather;

5. Implement measures to ensure that vulnerable T2D patients stay indoors and have access to cooling systems safely during extreme heat periods;

6. Make preparedness plans for medication and support for climatic disasters.

Ø At patient level, individuals should:

1. Be familiar with guidelines for disaster preparedness tailored for them;

2. Prepare a personal diabetes emergency plan and supply kit, during and after an emergency to maintain daily diabetes management and to help prevent acute health problems.

Ø Certain technologies could also be of great importance in geo-environmental diabetes management:

1. Geographic information systems for mapping urban areas with increased patient vulnerability to heat;

2. Wireless transmission of personal blood glucose data by patients to a centralized electronic health record system for early detection of epidemic disease outbreaks;

3. Centrally monitoring individual glucose control during extreme weather for early intervention (e.g. a phone call to the patient to provide advice on whether to seek medical attention);

4. Real-time methods (e.g., transmission of mobile text messages by local area weather services) for communication of weather advisories to patients with diabetes.

Key take home messages:

Ø The climate crisis and diabetes/ obesity pandemics are interconnected health issues which have common predisposing vectors and magnify each other's impacts.

Ø The three shared common global vectors are increased urbanisation, increased reliance on mechanized transportation and increased production and consumption of meat and ultra-processed foods.

Ø Both crises have shared common solutions - public health actions for lifestyle changes and sustainable urbanisation.

Ø Health professionals should guide a joint action on tackling climate - health issues