Diabetes story misses key angle.
In a feature story about the dramatic growth of diabetes in India, the BBC completely ignores emerging evidence of the role of contamination in causing the disease.
Observing 'World Diabetes Day,' the BBC is running a story by Adam Mynott about how rapidly type 2 diabetes is spreading in India.
According to the BBC, "Officially there are 41 million Indians with the disease, but in Chennai, Tamil Nadu as many as 15% of the population suffer." In a span of some 15 years, the prevalence of diabetes in Chennai increased by more than 70%.
BBC presents the conventional interpretation of why this is happening: the Western life style of rich foods and reduced exercise is spreading rapidly through India and other developing countries.
No where in BBC's coverage is there even the slightest hint of a large body of scientific literature on the possible role of contamination. As long as the media and public health officials ignore this, they won't explore ways that reducing contamination might be used to avoid diabetes in the first place.
Multiple studies now show strong epidemiological links between pollution and type 2 diabetes. For example, research by Lee et al., using data from the US Centers for Disease Control, finds dramatic increases in diabetes risk associated with exposure to a mixture of persistent organic pollutants (POPs) like dioxins and PCBs. This graph, adapted from Lee et al., shows that people in the US with higher levels of exposure to POPs are at much greater risk to type 2 diabetes. |  |
Lee et al.'s data are from the NHANES data set, which is carefully structured to obtain a sample representative of people living in the US. The exposure groups (1 through 5) reflect increased exposure to a mixture of POPs, not just one chemical at a time. And the amounts even in the most exposed group are not out of the ordinary; they are background levels experienced not just by many people in the US but also by many people around the world.
Perhaps the biggest surprise in these results is that when Lee et al. examined just those people in the lowest exposure group (group 1), they found no relationship between obesity and risk of type 2 diabetes. This unexpected result could be interpreted to indicate that without exposure to pollutants, obesity does not increase the risk to diabetes. This runs so counter to traditional wisdom that it must be replicated.
Persistent organic pollutants, moreover, are not the only contaminant linked to increased risk of type 2 diabetes. In August and September 2008, two papers were published linking bisphenol A in people to the disease. One tied bisphenol A (BPA) to decreased levels of a hormone, adiponectin, that protects against heart disease and diabetes. The second, published in JAMA, was the first large epidemiological study in people of BPA. It reported a highly significant association between BPA exposure and diabetes risk.
Large experimental literatures with animals support these human studies with details of how contaminants interfere with insulin metabolism in ways consistent with causation of insulin resistance and type 2 diabetes.
Most certainly, contaminants are not the only factors contributing to the global epidemic of type 2 diabetes. But strong scientific evidence now implicates them squarely in the causation of some fraction of that horrific disease burden. By ignoring this information completely, the BBC helps perpetuate a frame that ignores potential interventions that could lead to prevention and thus a reduction in the human and economic toll this epidemic is imposing on people around the world. Surely the BBC can do better.
