Arsenic and type 2 diabetes: Revealing the environmental exposure relationship through effective factors - A systematic review

This systematic review focoused on exploring the link between environmental exposure to arsenic (in air, water, and food pathways) and the occurrence of type 2 diabetes mellitus (T2DM). A comprehensive search was carried out in PubMed, Scopus, Web of Science, and Embase databases without time and location limits. The inclusion criteria were studied, and 121 records were included after full screening. The reviewed studies primarily focused on arsenic levels in water samples, followed by urine, blood, serum, and plasma samples analysis. Air, food, diet, nail, and tear samples were in the next rank. Many studies concentrated on females and occasionally pregnancy. Some explored arsenic's impact in occupational settings, while others investigated age, obesity, body mass index, and genetic effects. A few studies were related to the Strong Heart Study (SHS), additives, vitamin D, growth promoters, and agricultural product ripening. Arsenic can contaminate groundwater sources, particularly in areas with natural deposits of arsenic or due to industrial activities. Arsenic can be present in certain foods, especially rice, seafood, and poultry; it is also possible to be emitted into the atmosphere via industrial processes such as mining, smelting, and coal combustion and cause occupational exposure. Genetic elements could also contribute to the link between arsenic exposure and the development of T2DM. This association has been observed in both occupational settings and populations with high levels of arsenic in their diets. In the field of limitations, there was restricted data available regarding the gender-specific effects of environmental arsenic exposure on the onset of T2DM, as well as the connection between arsenic exposure, age, and T2DM development. However, the exact molecular mechanisms still need to be fully understood for the correlation between arsenic exposure and T2DM.