Air pollution and its role in the rising burden of type 2 diabetes in India: urgent call for action.

India is rapidly becoming the global epicenter of type 2 diabetes (T2D), a complex disease influenced by multiple factors including diet, lifestyle, urbanization, genetics, and environmental exposures such as air pollution. The rapid pace of urbanization, coupled with growing population density, exacerbates air pollution levels in major Indian cities, with pollutants such as particulate matter (PM2.5), (PM10), nitrogen dioxide (NO2), nitrogen oxides (NOX), and carbon monoxide (CO) being significantly elevated in comparison with the rural areas. These pollutants have been implicated in the pathogenesis of T2D, by inducing insulin resistance, oxidative stress, and endothelial dysfunction leading to vascular complications of T2D. International studies also highlight a similar association between air pollution and the incidence of T2D. The multifactorial nature of the disease, combined with the myriad of contributing environmental and lifestyle factors, makes it challenging to pinpoint specific risk elements. To mitigate the impact of these combined factors, continuous monitoring of air quality is imperative. Monitoring of traffic emissions, promotion of electric vehicles (EVs), and enhancement of mass transit options can each mitigate the impact of air pollution on type 2 diabetes. Furthermore, the integration of artificial intelligence (AI) and machine learning (ML) can optimize these interventions, making them even more effective. Urban planning strategies focused on increasing green spaces, afforestation, and sustainable construction practices are essential for long term health benefits. Collectively, these solutions present a holistic approach to combating T2D and improving public health amidst the challenges posed by urbanization and environmental pollution in India.