Endocrine System Disruptions and Diabetes Mellitus Connections: An Updated Review and The Role of Family Medicine

Abstract

Background: Diabetes mellitus (DM) is a global metabolic disorder characterized by chronic hyperglycemia and its associated health burdens. While traditional factors such as diet and inactivity are well-established contributors, recent attention has shifted to endocrine-disrupting chemicals (EDCs) as potential drivers of DM. Persistent and non-persistent EDCs disrupt hormonal pathways, contributing to insulin resistance and glucose intolerance.

Aim: This review examines the role of EDCs, particularly persistent organic pollutants (POPs) and bisphenol A (BPA), in the pathogenesis of DM, emphasizing their metabolic and environmental interactions. The study aim also to investigate the main role of family medicine in diabetes and endocrinology.

Methods: A comprehensive review of epidemiological studies, clinical trials, and experimental data was conducted, focusing on the associations between EDC exposure and DM. Special attention was given to persistent POPs such as dioxins and polychlorinated biphenyls (PCBs), non-persistent chemicals like BPA, and emerging alternatives.

Results: Evidence suggests strong correlations between exposure to POPs and the prevalence of type 2 diabetes (T2D), with mechanisms including impaired insulin secretion and resistance. Non-persistent EDCs like BPA also exhibit significant associations with DM, even at low exposure levels. Emerging alternatives to BPA, such as bisphenol S (BPS), demonstrate similar risks, raising concerns about their safety. The dose-response relationship is non-linear, with low-dose exposures often more impactful than high doses.

Conclusion: EDCs represent critical environmental risk factors in DM development, compounding traditional contributors like obesity and lifestyle. While regulatory efforts have reduced certain EDCs, their persistent and non-persistent forms continue to pose significant challenges. Addressing these environmental toxins is imperative for mitigating DM risk globally. The study investigated the important role of family medicine in this condition.