Air pollution in India may be fueling diabetes and obesity, according to new research. Dr Arvind Kumar said, "There is now data to say that diabetes and even obesity, which is so rapidly increasing in our country, have been linked to air pollution." Toxic particles trigger inflammation, affecting insulin production.
Toxic particles can inflame the pancreas, affecting insulin production and blood sugar
Pulled into our lungs, travelling through our bloodstream and potentially disrupting our metabolism, air pollution may be contributing to India's diabetes and obesity epidemic.
Air pollution could be doing far more than damaging your lungs. Emerging research suggests that breathing toxic air over prolonged periods may increase the risk of developing type 2 diabetes, interfere with insulin metabolism and even contribute to weight gain and obesity.
And this could have particularly serious implications for India, which is already battling an enormous burden of diabetes and obesity.
In a conversation with NDTV Lifeline, renowned pulmonologist Dr Arvind Kumar warned that air pollution must no longer be viewed as merely a respiratory health problem.
"There is now data to say that diabetes and even obesity, which is so rapidly increasing in our country, have been linked to air pollution," Dr Kumar said while speaking on Health, Actually.
The warning comes against the backdrop of mounting scientific evidence linking long-term exposure to fine particulate matter, particularly PM2.5, with metabolic disorders.
So Can Breathing Dirty Air Fuel A Diabetes Crisis?
One of the most important studies to examine this question was published in the journal BMJ Open Diabetes Research & Care in October 2023.
Researchers studied 12,064 adults in Delhi and Chennai to investigate the relationship between PM2.5 exposure, blood glucose levels, HbA1c and the incidence of type 2 diabetes.
A 10 microgram per cubic metre increase in annual average PM2.5 exposure was associated with a 22% higher risk of developing type 2 diabetes.
The researchers also found that a 10 microgram per cubic metre increase in monthly average PM2.5 exposure was associated with a 0.40 mg/dL increase in fasting blood glucose and a 0.021-unit increase in HbA1c.
This is particularly significant for India, where diabetes is already a major public health challenge.
Dr Kumar explained the possible biological mechanism during his conversation with NDTV Lifeline.
"When these toxic particles go into the lungs, they get absorbed into the blood. And then they go to every organ in the body."
He added that when these particles reach the pancreas, they can trigger inflammation and interfere with insulin metabolism.
"When these particles get deposited in the pancreas, they cause inflammation there. And that disturbs the insulin metabolism. And you have less insulin," Dr Kumar explained.
The pancreas plays a central role in regulating blood sugar by producing insulin. Disruption of insulin production and signalling can contribute to metabolic dysfunction and diabetes.
So Is Pollution Making Us Obese?
The potential connection between air pollution and obesity is another emerging area of research.
Dr Kumar pointed out that the effects of toxic particles may extend to adipose tissue which is the body's fat-storing tissue.
"Likewise, when these particles get deposited in the adipose tissue, which is the fatty tissue, they again disturb the fat metabolism," he said during the NDTV Lifeline podcast, Health, Actually.
Another research points in this direction.
A systematic review and meta-analysis published in Environmental Research in 2026 examined 41 studies involving adults and found positive associations between exposure to PM2.5 and several obesity-related measurements.
The researchers found that higher PM2.5 exposure was associated with:
* 0.93 kg/m2 higher body mass index (BMI).
* 1.17 cm higher waist circumference.
* 1.60% higher waist-to-hip ratio.
The analysis also found associations between PM2.5 and increased risks of general and abdominal obesity.
The researchers cautioned that more longitudinal studies are needed to establish causality. Nevertheless, the findings add to concerns that environmental pollution could be an overlooked contributor to the obesity epidemic.
How Does Polluted Air Affect Your Metabolism?
The mechanism is increasingly being investigated by researchers.
Fine particulate matter can trigger oxidative stress and inflammation. These processes may affect several organs involved in regulating blood sugar and energy balance, including the pancreas, liver, skeletal muscle and adipose tissue.
A systematic review and meta-analysis published in 2018 examined the relationship between air pollution and insulin resistance. It found associations between certain pollutants, including nitrogen dioxide and PM10, and changes in insulin resistance markers.
A 2025 review in Frontiers in Endocrinology established the same.
This is important because insulin resistance is a key feature of type 2 diabetes.
However, researchers are still investigating precisely how much of the relationship is directly attributable to pollution, and how it interacts with other risk factors such as diet, physical inactivity, genetics and socioeconomic conditions.
As a pulmonologist and chest surgeon who is seeing Delhi NCR's air pollution worsen over the years, this is a link established without a doubt, says Dr Kumar.
Clearly India's pollution problem could have consequences beyond the lungs.
"There are three or four other areas where there is solid evidence available of horrible damage being caused," he said, referring to the wider effects of air pollution on the human body.
He pointed to cardiovascular disease, hypertension, stroke and neurological disorders, besides diabetes and obesity.
India's diabetes and obesity crisis may have environmental dimensions that are not receiving enough attention.
Pollution cannot be considered the sole cause of either condition. Diet, physical activity, genetics, sleep, age and other factors remain important. But mounting evidence suggests that the air people breathe could be another significant piece of the metabolic health puzzle.
"The lungs are the point of entry, but the damage can travel much further. The question is no longer simply whether polluted air makes us cough or struggle to breathe" Dr Arvind said.