How Nuclear Radiation May Influence Diabetes Risk
How Nuclear Radiation May Influence Diabetes Risk
Exposure to low-level nuclear radiation may increase the risk of developing diabetes, according to findings presented at the annual meeting of the European Association for the Study of Diabetes.
A retrospective study of adults involved in emergency response efforts following the 2011 Fukushima Daiichi nuclear power plant disaster in Japan found that people exposed to 10 to 49 millisieverts (mSv) of radiation had an increased risk of developing diabetes compared with those who were exposed to little or no radiation.
“Healthcare providers should consider more vigilant screening for diabetes in individuals with a history of low-dose radiation exposure, such as nuclear emergency workers, to enable early identification and treatment, which may help reduce associated health risks,” researcher Huan Hu, PhD, of the National Institute of Occupational Safety and Health in Kawasaki, Japan, said in an interview with Healio. The recommendation comes after a study analyzing data from 5,326 adults who participated in the Epidemiological Study of Health Effects in Fukushima Nuclear Emergency Workers, which aims to track long-term health outcomes in workers exposed to radiation after the 2011 Fukushima Daiichi nuclear power plant accident. Diabetes cases were identified based on a fasting plasma glucose level of at least 126 mg/dL, an HbA1c level of 6.5% or higher, or a self-reported diagnosis. Radiation exposure was assessed using personal pocket alarm dosimeters for external exposure and whole-body counters for internal exposure. From 2012 to 2021, 392 participants developed diabetes. In multivariable-adjusted analyses, those exposed to 10 to 19 millisieverts (mSv) of radiation had a 47% higher risk of developing diabetes (adjusted hazard ratio [aHR] = 1.47; 95% CI, 1.12–1.94), and those exposed to 20 to 49 mSv had a 33% higher risk (aHR = 1.33; 95% CI, 1–1.77) compared with those exposed to 0 to 4 mSv. No increased risk was found in individuals exposed to 5 to 9 mSv or 50 mSv or more compared with the reference group.
“Further research is needed to clarify the association between low-dose radiation exposure and the risk of developing diabetes,” Hu said. “This may include extending the follow-up period to capture additional cases of diabetes, allowing for a more thorough analysis. In addition, mechanistic studies are important to understand better the underlying biological processes and potential health risks associated with low-dose radiation, which may help guide strategies to protect those at risk.”
The relationship between radiation exposure and diabetes/obesity
Only a few peer-reviewed studies have examined the relationship between radiation exposure and conditions such as diabetes or obesity. Some human studies indicate that high doses of radiation may play a role in the development of either type 1 or type 2 diabetes. However, the potential effect of lower radiation doses has not yet been studied to a large extent, leaving a significant gap in current research.
Type 1 diabetes and autoimmunity
After the 1986 Chernobyl nuclear disaster, an increase in the incidence of type 1 diabetes was reported in the Gomel region of Belarus. Studies found that the average rate of new type 1 diabetes cases increased in the years following the accident compared with the years before (Martinucci et al., 2002). When comparing the highly exposed Gomel region to the less exposed Minsk region, researchers found a significantly greater increase in the incidence of type 1 diabetes in Gomel (Zalutskaya et al., 2004). However, a similar study conducted in Poland found no increased risk of diabetes in individuals exposed to high radiation levels (Bandurska-Stankiewicz and Rutkowska, 2004).
Other autoimmune diseases have also been reported in Belarusian children after Chernobyl, including autoimmune thyroid disorders (Lomat et al., 1997). In the United States, adults living near abandoned uranium mines in the Navajo Nation were found to have higher levels of autoantibodies, possibly due to long-term exposure through contaminated drinking water (Erdei et al., 2019).
Animal studies have provided mixed information. A laboratory study found that long-term exposure to radiofrequency radiation emitted by cell phones did not affect insulin secretion in rats, but did result in more dilated pancreatic islets, although the relevance of this finding to diabetes is still unclear (Mortazavi et al., 2016). Another study found that exposure to Wi-Fi radiation in rats increased blood sugar, increased oxidative stress, and decreased insulin secretion (Massoumi et al., 2018).
Type 2 diabetes and insulin resistance
Several studies have linked radiation exposure to an increased risk of type 2 diabetes and insulin resistance. In Hiroshima, survivors of the atomic bombing showed an increased incidence of diabetes in the decades following the event (Ito, 1994). Similarly, workers involved in the cleanup of the Chernobyl disaster were found to have elevated insulin levels – an early indicator of insulin resistance and a precursor to type 2 diabetes (Zueva et al., 2001). Additional research from Chernobyl also reported higher rates of diabetes, pre-diabetes, obesity, and pre-obesity in both survivors and cleanup workers (Kaminsky et al., 2015).
Exposure to ionizing radiation, such as during cancer treatment, also leads to the later development of insulin resistance and type 2 diabetes. Animal studies suggest that epigenetic changes may contribute to this effect (Nylander et al., 2016). Supporting this, children who undergo whole-body radiation as part of cancer therapy often develop insulin resistance (Lorini and D’Annunzio, 2005).
In a study involving monkeys, those exposed to high doses of whole-body radiation had a significantly higher risk of developing diabetes 5 to 9 years after exposure. These animals also showed increased insulin resistance despite having less body fat than non-exposed controls (Kavanagh et al., 2015).
Although this is not a direct causal relationship, the Oceania region, subjected to nuclear weapons testing between 1946 and 1958, experienced the largest global increase in fasting blood sugar levels from 1980 to 2008 and reported the highest diabetes prevalence by 2008 (Danai et al., 2011; Simon et al., 2010). The region continues to experience both acute and chronic radiation exposure. In terms of non-ionizing radiation, a study from Saudi Arabia found that adolescents attending a school located near a cell phone base station – which was exposed to high electromagnetic fields – had significantly higher HbA1c levels and a greater risk of developing type 2 diabetes than students in a school with less exposure (Meo et al., 2015).
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