The relationship of short-term exposure to meteorological factors on diabetes mellitus mortality risk in Hefei, China: a time series analysis

The study aims to explore whether short-term exposure to meteorological factors has a potential association with the risk of diabetes mellitus (DM) mortality.

During the period 2015–2018, we collected daily data on meteorological factors and deaths of diabetic patients in Hefei. A total of 1101 diabetic deaths were recorded. We used structural equation modeling to initially explore the relationships among air pollutants, meteorological variables, and mortality, and generalized additive modeling (GAM) and distributional lag nonlinear modeling (DLNM) to explore the relationship between meteorological factors and the mortality risk of DM patients. We also stratified by age and gender. The mortality risk in diabetic patients was expressed by relative risks (RR) and 95% confidence intervals (CI) for both single and cumulative days.

Single-day lagged results showed a high relative humidity (RH) (75th percentile, 83.71%), a fairly high average temperature (T mean) (95th percentile, 30.32 °C), and an extremely low diurnal temperature range (DTR) (5th percentile, 3.13 °C) were positively related to the mortality risk of DM. Stratified results showed that high and very high levels of T mean were significantly positively linked to the mortality risk of DM among females and the elderly, while very high levels of DTR were linked to the mortality risk in men and younger populations.

In conclusion, this study found that short-duration exposure to quite high T mean, high RH, and very low DTR were significantly positively related to the mortality risk of DM patients. For women and older individuals, exposure to high and very high T mean environments should be minimized. Men and young adults should be aware of daily temperature changes.