Diabetes and Endocrinology
How Will Climate Change Affect Endocrinology?
Climate change may result in increased incidence of diabetes, as increased temperatures have been associated with impaired glycaemic control and insulin resistance. Temperatures above 30C can damage injectable insulin and preventing from working properly.
Additionally, changes in temperature and precipitation as a result of climate change can worsen air quality, which is also associated with an increased risk of developing diabetes.
Those who already have diabetes may be affected by climate change in a multitude of ways. Extreme heat, cold temperatures and air pollution have all been associated with increased risk of diabetic complications, and extreme weather events such as flooding have been associated with impaired glycaemic control. In addition, climate change is predicted to aggravate the transmission of some infectious diseases, a particular risk for those with diabetes.
Thyroid function has also been found to be affected by air pollution exposure, and TSH levels have been shown to have seasonal variability, meaning thyroid disorders may also be affected by changes in climate conditions.
In addition, for people with many endocrine disorders, extreme weather events can result in reduced access to health care services or medication.
How is Endocrinology Affecting Climate Change?
Endocrinology care, in particular the management of diabetes and diabetic complications, produces large amounts of carbon emissions, for example from the use of hospital facilities during admissions, or travel to appointments. However, when type 2 diabetes is well managed, the carbon emissions may be 7% lower than poorly managed cases.
As with many other specialities, endocrinology contributes to climate change through patient travel, use and production of medicines and medical equipment. Additionally, diabetes care involves large amounts of single use plastic – from insulin pens, lancets and test strips, for example. This plastic waste often ends up in landfill.
Discussion Ideas with Patients and Colleagues
Patients:
"When the weather changes, for example it is particularly hot or cold, it is especially important to monitor your blood sugar levels, as your diabetes control may be different to when the weather is more mild."
"If temperatures are likely to reach above 30C, make sure you store your insulin in a cool place otherwise it might not work."
"When extreme weather is predicted, such as heavy rains or particularly hot weather, it is important that you ensure you have supplies of your regular medication, as you may find that flooding or heatwaves make you less able to get to your pharmacy to get the medication."
Colleagues
"Is there any scope to increase our prescribing of reusable insulin pens to reduce the plastic waste coming from single use pens?"
Highest Impact Actions for Endocrinology Departments
Embed climate change and healthcare sustainability regularly into education and governance
Help to prevent diabetes and obesity at the earliest stages by encouraging dietary and lifestyle changes, such as encouraging a more plant-based diet.
Help patients to better manage their conditions in order to avoid disease complications and subsequently reduce the overall environmental impact of their care.
Choose to prescribe reusable insulin pens where available. If not available, check what the local provisions are for insulin pen recycling or set up a recycling scheme in your own department and encourage patients to utilise this.
For More Information
Visit the Centre for Sustainable Healthcare for networks, quality improvement ideas and the latest research