Persistent Organic Pollutants and Diabetes Mellitus: Correspondence.

Dear Editor,

We would like to share ideas on “Persistent organic pollutants—environmental risk factors for diabetes mellitus?—A population-based study.[1] ” Ramalingam et al.[1] concluded that “Three OC pesticides and one organophosphate pesticide were strongly associated with increasing blood sugar levels …….” We agree that an environmental chemical hazard might induce problems including diabetes. However, a pathological process should last long and a cross-sectional study can only tell a point association. The pathogenesis is interesting. Whether toxic substances disturb pancreatic endocrine function or induce gluconeogenesis requires further studies. Additionally, blood glucose is a rough estimation. The hexokinase method is an old technique with possible laboratory interference.[2] Examples of interfering substances are hemoglobin and bilirubin.[2] Hemoglobin A1C determination might be a useful parameter to support whether there is a poor nutritional behavior that might be associated with diabetes. Diabetes may be present in a subject who has a poor health behavior or lifestyle, has been exposed to toxic substances, and has poor nutritional practices.

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