Sung Kyunghun, Lee Seung-Hwan
Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Diabetes Investig. 2025 Jun;16(6):971-983. doi: 10.1111/jdi.70024. Epub 2025 Mar 18.
Type 2 diabetes mellitus (T2DM) is a major global public health challenge driven by a complex interplay of genetic, environmental, and social factors. This review highlights the effects of social determinants of health (SDOH) on T2DM in Asia, where rapid urbanization, worsening air pollution, and distinct socioeconomic structures uniquely influence disease outcomes. Key SDOH domains, socioeconomic status (education, income, and occupation), physical environment, food environment, healthcare access, and social context, were analyzed for their associations with T2DM prevalence, progression, and management. Among these, environmental and lifestyle shifts have emerged as particularly influential factors in Asia. Air pollution, particularly fine particulate matter, has been increasingly linked to insulin resistance and diabetes risk in Asian populations. Additionally, rapid urbanization and changing food environments contribute to rising T2DM incidence through shifts in lifestyle and dietary patterns. Across the diverse healthcare systems of Asian countries, primary care remains a universally critical component in addressing T2DM issues. Additionally, social capital and cohesion serve as protective factors, whereas social isolation heightens vulnerabilities. These insights underscore the importance of addressing SDOH in public health strategies to combat T2DM in Asia. Future research should prioritize longitudinal studies and culturally tailored interventions to reduce the region's diabetes burden.
2型糖尿病（T2DM）是由遗传、环境和社会因素复杂相互作用驱动的一项重大全球公共卫生挑战。本综述强调了健康的社会决定因素（SDOH）对亚洲T2DM的影响，在亚洲，快速城市化、空气污染加剧以及独特的社会经济结构对疾病结局有着独特的影响。分析了关键的SDOH领域，即社会经济地位（教育、收入和职业）、物理环境、食物环境、医疗保健可及性和社会背景与T2DM患病率、病情进展及管理之间的关联。其中，环境和生活方式的转变已成为亚洲特别有影响力的因素。空气污染，尤其是细颗粒物，与亚洲人群的胰岛素抵抗和糖尿病风险的关联日益增加。此外，快速城市化和不断变化的食物环境通过生活方式和饮食模式的转变导致T2DM发病率上升。在亚洲国家多样化的医疗体系中，初级保健仍然是解决T2DM问题的普遍关键组成部分。此外，社会资本和凝聚力起到保护作用，而社会孤立则会增加脆弱性。这些见解强调了在公共卫生战略中应对SDOH以抗击亚洲T2DM的重要性。未来的研究应优先开展纵向研究和针对不同文化的干预措施，以减轻该地区的糖尿病负担。
