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This review is undertaken to address the possible role of arsenic and pesticides in the prevalence of diabetes in Pakistan and to highlight a resourceful targeted research in this area.  A bibliographic search of scientific databases was conducted with key words of “epidemics of diabetes in Pakistan”, “diabetes in Asia”, “diabetes mellitus and environmental pollutants”, “diabetes mellitus and heavy metals”, “diabetes mellitus and pesticides”, “prevalence of pesticides in Pakistan”, and “heavy metals contamination of drinking water, “vegetables and fruits in Pakistan”. More than 200 articles were examined. Studies reporting the prevalence of diabetes mellitus (DM), pesticides and heavy metal contamination of drinking water, fruits and vegetables were included in the study. According to WHO 2011 report, about 12.9 million people are suffering from DM and the number is constantly increasing. Water pollution is a major public health threat in Pakistan. Most of the people in Pakistan are exposed to arsenic and pesticides either in drinking water or through vegetables, fruits, and other edible items with various concentrations above the WHO/FAO permissible limits. Being an agricultural country, a 1169% increase has been recorded with the use of different types of pesticides since last two decades, and almost similar rise in the burden of diabetes.  There is a growing global concern of arsenic and pesticides exposure with the incidence of DM. Besides other factors, the environmental attributors in the incidence of DM in Pakistan have not been conclusively elucidated yet which in turn deserve a resourceful targeted research.

Growing burden of diabetes in Pakistan and the possible role of arsenic and pesticides