Association of Urine Heavy Metals with Prevalence of Type 1 Diabetes and Poor Glycaemic Control

Emerging evidence suggests that endocrine-disrupting chemicals specifically heavy metals, may influence metabolic disorders including Type 1 Diabetes mellitus (T1DM). Poor glycaemic control is a key issue in management of T1DM. This cross-sectional study explores the association of toxic heavy metals with prevalence of T1DM and glycaemia. A total of 153 individuals with T1DM with mean age of 13 years and age- and sex matched 60 healthy controls from Coimbatore, South India were recruited. Clinical data including glycated haemoglobin and sociodemographic and environmental exposure data were collected. Urine samples were analysed for Copper (Cu), Zinc (Zn), Cadmium (Cd), Arsenic (As), Barium (Ba) and Lead (Pb), which are all known endocrine-disrupting chemicals. Urinary concentrations of all heavy metals were normalized to urine creatinine and expressed as ug/mg creatinine. The levels of all analyzed metals were significantly higher in T1DM compared to controls. Correlation analysis revealed the positive association between glycaemia and heavy metals. Arsenic and lead showed significant trend with T1D prevalence on comparison to control while zinc and cadmium showed significant trend with uncontrolled glycaemia. This study reveals the association of heavy metals exposure on the etiology and pathophysiology of T1DM. In addition, this study highlights the need of screening of urinary heavy metals as part of metabolic risk assessment and development of targeted therapies for heavy metal detoxification for achieving better glycaemia in T1DM.