Lipophilic chemical exposure as a cause of type 2 diabetes (T2D)

Rev Environ Health. 2013;28(1):9-20. doi: 10.1515/reveh-2012-0031.


The prevalence of type 2 diabetes (T2D) is increasing worldwide in pandemic-like numbers. It is considered, at least in part, to be an environmental illness. Recent research has shown that diabetes can be caused by exposure to persistent organic pollutants (POPs), exudates from common plastics, air pollution, primary and secondary tobacco smoke, and some pharmaceuticals. These chemicals vary widely in structure, chemical properties, and composition and are not currently believed to induce a similar effect. A unifying explanation for the induction of T2D by this diversified group of chemicals is proposed here. These toxicants have one thing in common. All are lipophilic species that permeate lipophilic body membranes, thereby promoting the absorption of toxic hydrophilic species that would otherwise not penetrate lipophilic membranes. It is further proposed that exposure to the lipophilic and hydrophilic species need not occur simultaneously but can occur sequentially, with the lipophile absorbed first and retained in body serum, followed by a subsequent exposure to the hydrophile. The lipophilic chemical can be one of the POPs (including dioxins, furans, polychlorinated biphenyls, polybrominated biphenyls, polybrominated diphenyl ethers, or organochlorine pesticides); a more rapidly metabolized or eliminated species including plastic exudates like phthalate esters and bisphenol A; air pollutants and tobacco smoke components including aliphatic, aromatic, or polynuclear aromatic hydrocarbons; or pharmaceuticals like some statins and second-generation antipsychotic drugs. This hypothesis suggests that the T2D pandemic as well as the rapid increase of other environmental disease prevalence is, at least in part, due to sequential exposure to levels of lipophilic and hydrophilic environmental pollutants that are much lower than those currently believed to be toxic. As a consequence of this hypothesis, the allowable levels of exposure to these pollutants should be dramatically lowered.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / drug effects*
  • Cluster Analysis
  • Diabetes Mellitus, Type 2 / chemically induced*
  • Environmental Pollutants / toxicity*
  • Humans


  • Environmental Pollutants