November 14 is World Diabetes Day, when the global health community focuses on raising awareness of diabetes and how to prevent, manage, and live well with it. This year’s theme from the World Health Organization emphasizes that “diabetes can affect people at every stage of life, ” and that prevention and care must be woven into every stage of that journey.
If you’re living with prediabetes, you still have a powerful opportunity to change your trajectory and steer away from full-blown type 2 diabetes. For those who are genetically predisposed to diabetes, you have even more time for prevention. And one of the lesser-known but important tools in your prevention toolbox? Air quality—both outdoors and indoors.
Background on Type 2 Diabetes
Type 2 diabetes is a long-term condition where the body either resists the effects of insulin—the hormone that helps sugar (glucose) move from the blood into cells—or doesn’t make enough insulin to keep blood sugar at a healthy level. Over time, too much glucose in the blood can damage blood vessels, nerves, and organs. If untreated, it can lead to serious complications such as vision loss, amputation, kidney disease, and stroke.
By contrast, type 1 diabetes is when the body’s immune system destroys the crucial insulin-producing cells in the pancreas. This means people with type 1 must take insulin for life.
Type 2 diabetes develops gradually, historically in older adults, but it is increasingly common in teens and children—which is often attributed to the obesity epidemic. It’s linked to weight, physical inactivity, unhealthy diets, and environmental exposures. Because it develops slowly, there’s a crucial window of prevention—a time when lifestyle and environmental changes can stop or delay its onset.
What is Prediabetes and Why It Matters
Prediabetes means your blood sugar levels are higher than normal but not yet high enough for a diabetes diagnosis. According to the 2024 National Diabetes Statistics Report from the CDC, one in three U.S. adults has prediabetes—and most don’t know it.1
A simple blood test can detect it, and early action can prevent or delay type 2 diabetes. Once diabetes sets in, however, the risks of heart disease, kidney failure, nerve damage, and vision loss rise sharply.
Globally, the economic impact is staggering: the International Diabetes Federation reports that diabetes now costs at least $1 trillion a year in healthcare—a 338% increase in just 17 years.2
So if you’re prediabetic, this is the time to act. That includes traditional lifestyle interventions such as weight-management, diet, and exercise, as well as environmental exposures like air quality. It may help to frame your prevention strategy in the “life-course” mindset: this isn’t just about avoiding diabetes now—it’s about building a healthier metabolic trajectory for the rest of your life.
The Life-Course Approach
The “life-course approach” is a framework used in public-health for non-communicable diseases (NCDs) like type 2 diabetes, cancer, and chronic respiratory diseases. Simply put: health risks and prevention opportunities accumulate across all life-stages—from before birth, through infancy, childhood, adolescence, adulthood and old age.3
For diabetes prevention, that includes everything from maternal nutrition and air pollution exposure during pregnancy to diet, activity, and environment throughout childhood and adulthood. Older age adds further challenges, such as multiple health conditions and reduced resilience.
Even if you’re a grown adult with prediabetes, treating your prevention plan as part of your “life-course” (i.e., cumulative exposures and habits over time) helps you meaningfully intervene now, before it is too late. And one of the most overlooked is reducing exposure to air pollution.
The Science: Air Pollution and the Risk of Type 2 Diabetes
A growing body of evidence links air pollution—particularly fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3)—to the development of insulin resistance, prediabetes, and type 2 diabetes. Together, these studies reveal that air pollution is not only a respiratory or cardiovascular hazard, but also a significant metabolic one.
One of the strongest longitudinal data sets comes from researchers who followed more than 3,500 adults aged 32 to 81 over a 16-year period to evaluate how long-term air pollution exposure affected metabolic health. They found that higher levels of PM2.5 and nitrogen dioxide were associated with measurable reductions in insulin sensitivity plus higher blood sugar levels. The authors concluded that chronic exposure to even moderate levels of air pollution contributes to the development of insulin resistance—a pivotal early step in the development of type 2 diabetes.4
A cross-sectional study conducted between 2018 and 2020 in two heavily polluted Chinese cities found that long-term exposure to common air pollutants—including fine and coarse particulate matter (PM1, PM2.5, PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3)—was linked to higher risks of prediabetes and diabetes. O3 exposure, in particular, was associated with elevated fasting glucose, insulin, and insulin resistance, alongside reduced insulin sensitivity. The researchers also found evidence suggesting that chronic inflammation may be a key biological pathway connecting air pollution to metabolic dysfunction.5
Most recently, a 2025 study conducted in Taiwan and Hong Kong took the “life-course” approach and explored how pollution exposure at different points in life affects metabolic outcomes. Researchers found a clear relationship between lifetime exposure to PM2.5 and the prevalence of both prediabetes and type 2 diabetes in adulthood. Exposure during adulthood had slightly stronger effects than in childhood, but the study underscored an important truth: every stage of life matters, and risks accumulate over time.6
These are only a sample of the recent research demonstrating that air pollution can act as both a trigger and an accelerator of metabolic disease.
How Air Pollution Can Exacerbate Existing Diabetes
For people already living with type 2 diabetes, poor air quality can make managing the disease harder. Pollution can increase inflammation and oxidative stress, reduce blood vessel function, and heighten insulin resistance—all of which make it more difficult to keep blood sugar stable. Higher pollution levels have also been linked to spikes in blood sugar and a greater risk of heart and kidney complications in people with diabetes.7
For someone managing type 2 diabetes, higher pollutant levels may mean harder blood-sugar control, greater cardiovascular risk, and increased burden of complications.
Protecting Children and Families
Following the guidance of the life-course approach, it is important to prevent air pollution exposure, before prediabetes enters the picture. Children are especially vulnerable to air pollution because their lungs and immune systems are still developing, and they breathe faster than adults.
Parents should be mindful of air quality alerts and avoid letting kids play outside when pollution levels are high. Indoors, using a high-efficiency Austin Air Purifier, keeping windows closed on poor air-quality days, and reducing indoor sources of smoke and fumes can make a real difference.
Protecting children from early exposure is a meaningful way to prevent long-term metabolic and respiratory harm—setting them up for healthier outcomes across their entire life course.
In Closing
On this World Diabetes Day, it’s worth remembering that type 2 diabetes is not inevitable. If you’re prediabetic, you have time, choice, and tools—including air purifiers.
By embracing the life-course approach—being mindful of past exposures, proactive in the present, and protective of the next generation—you can reduce your risk, support your metabolic health, and breathe a little easier.
And while an Austin Air Purifier isn’t a magic cure, it’s a smart and supportive step. If you’re already investing in healthier food, movement, and monitoring your health, improving your air quality helps your body stay in balance.
Here’s to cleaner air, steadier blood sugar, and a healthier future—for you and your family.
REFERENCES
1 National Diabetes Statistics Report. (2024 May 15). Centers for Disease Control. https://www.cdc.gov/diabetes/php/data-research/.
2 Diabetes Atlas. (2025 June 17). International Diabetes Foundation. https://diabetesatlas.org/.
3 Mikkelsen B, Williams J, Rakovac I, et al. (2019 January 28). Life course approach to prevention and control of non-communicable diseases. BMJ. 364:l257. doi: 10.1136/bmj.l257.
4 Zhang S, Mwiberi S, Pickford R, et al. (January 2021). Longitudinal associations between ambient air pollution and insulin sensitivity: results from the KORA cohort study. The Lancet Planetary Health. 5(1):e39 - e49. doi: 10.1016/S2542-5196(20)30275-8.
5 Mei Y, Li A, Zhao J, et al. (2023 January 1). Association of long-term air pollution exposure with the risk of prediabetes and diabetes: Systematic perspective from inflammatory mechanisms, glucose homeostasis pathway to preventive strategies. Environ Res. 216(Pt 1):114472. doi: 10.1016/j.envres.2022.114472.
6 Yi Y, Guo C, Zheng Y, et al. (2025 January 2). Life Course Associations Between Ambient Fine Particulate Matter and the Prevalence of Prediabetes and Diabetes: A Longitudinal Cohort Study in Taiwan and Hong Kong. Diabetes Care. 48(1):93–100. doi: 10.2337/dc24-1041.
7 Li Y, Xu L, Shan Z, Teng W, Han C. (2019 December 24). Association between air pollution and type 2 diabetes: an updated review of the literature. Ther Adv Endocrinol Metab. doi: 10.1177/2042018819897046.
