Type 2 Diabetes far more than just a sweet problem, exploring night light, night noise and other technological connections. By Dr Chris Barnes Bangor Scientific and Educational Consultants. First published on Internet 16^th September 2015. Email manager@bsec-wales.co.uk

Abstract

The effects of LAN ( light at night), lighting types, night noise and other modern technologies and medical interventions on type 2 diabetes prevalence is explored. Recently type 2 diabetes incidence increase has outstripped mean body weight increase and the reasons for this are explored. The hypothesis that LAN and sleep disturbances due to night noise and possibly even mobile phone emissions may at least in part be responsible for the recent increases in type 2 diabetes is supported in data from the UK and Scotland and to some extent also those data from the USA. In the latter the situation is more complex and socioeconomic factors are also at work. The night noise hypothesis where s elegantly supported in the data from Scotland where the annual step change increase between 2005 and 2006 of approximately 40,000 newly diagnosed cases is approximately double that of the preceding years most likely as a result of additional night noise due to the commencement of all night pub opening in that era.

Introduction

Type 2 diabetes occurs when the Islets of Langerhans in the pancreas are literally ‘exhausted’. Traditionally, this has been ascribed to certain genetic traits and to lifetime over production of insulin due to excessive levels of sugar and other high glycaemic index carbohydrates in diet. Strong support for the former is that type 2 as well as of course type 1 diabetes is known to run in families. Support for the latter comes from the knowledge that type 2 incidence has increased in the last four or five decades since the prevalence of both fast foods and the introduction of glucose-fructose syrup as a significant dietary component of many.

Obesity prevalence is seen to increase more or less in line with total fructose until the mid-1980’s and significantly more steeply thereafter. There is a close association between weight gain/obesity and type 2 diabetes. Although since 1996 diabetes has actually increased faster than mean body weight, suggestive of a further causal mechanism.

Data for statin prescription in England more or less maps the US trend in diabetes. One has to assume that prescription rates of these newly discovered drugs would have proceeded at similar rates in these two advanced countries. Regarding the 1990’s, now accepted as relevant here is that the world’s first commercial statin drugs went on sale in 1987, see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108295/ and http://www.mirror.co.uk/news/uk-news/uks-most-popular-statin-raises-5353696.

Lesser known is the notion that type 2 incidence actually fell slightly during WW2 when there was food rationing.

Presumably and interestingly in WW2 not only would food have been rationed but artificial light at night too would have been virtually absent due to blackouts.

It is the purpose of this paper, however, not to deny the readily accepted causes of type 2 diabetes, rather merely to ask the question are there any other modern day environmental factors which are accentuating its current explosion. An explosion which began circa the mid 1970’s and began to accelerate again steeply after in the 1990’s.

The 1970’s may be relevant in two ways. Extensive use of glucose –fructose syrup in the food and confectionary industry began here and it is accepted this significantly altered and advanced the course of type 2 diabetes incidence. Two lesser known technological changes I will also investigate are the commencement of all night TV broadcasting and the explosion of use of fluorescent lighting.

Moreover and further 1991’s other breakthroughs changed and are still changing the world

• 1991 was the year the first GSM call was made.

• 1991 was the year when the World Wide Web really came to life.

Perhaps we can add to this 1991 was the year thereafter where if we don’t appreciate what is happening, the great majority of the world’s population will eventually finish up with Type 2 diabetes.

The factors I will consider in detail with an association with type 2 diabetes are thus lighting types; light at night; all night TV broadcasting; light from screens and monitors and GSM and similar mobile phone and WIFI emissions.

Lighting types

From 1975-1985, type 2 diabetes rates were actually rising slightly while total fructose availability was either level or falling slightly.

In the same period the use of linear fluorescent lighting increased significantly. From about 2007 type 2 diabetes rates appear to be increasing even quicker than can be accounted for by statin prescription. Above it can be seen that this date corresponds with the start of the use of white LED lighting.

Light at Night.

It is well known that shift work is a risk factor for type 2 diabetes, see .. It is logical therefore to suppose that light at night ( LAN) may be a similar risk factor. Geospatial analysis is a powerful tool for testing such hypotheses which I have used previously and successfully for cancer epidemiology studies.

A significant geospatial correlation can be seen between light at night ( LAN) and both diabetes cases and diabetes attributable deaths, particularly the latter.

Other modern technology

Since 1991 there has been a phenomenal explosion in Internet and wireless ( mobile) technology. The most significant contributing factor to type 2 diabetes causation is in all probability exposure to bright light from screens, particularly at night although effects of sleep disturbances due to wireless technology cannot entirely be ruled out.

Discussion (LAN)

The above data sets strongly suggest an increased type 2 diabetes risk upon exposure to certain types of lighting, extra light at night and modern technology in general. Concurring with this present work, Fonken et al (2010) have suggested that the global increase in the prevalence of obesity and metabolic disorders coincides with the increase of exposure to light at night (LAN) and shift work. Barnes has suggested that there are similar effects on certain cancers, particularly hormonal cancers such as those of breast and prostate. Further at least in rodents, Fonken has shown that light at night increases body mass by shifting the time of food intake and supposes that similar mechanisms are at work in humans. Xu( 2009) has shown that Day Napping and Short Night Sleeping Are Associated With Higher Risk of Diabetes in Older Adults. Short night sleeping can of course be associated with sleep disturbances caused by any of a number of reasons including LAN, night noise and radio frequency technology. Obayashi et al (2012) have since confirmed LAN causes obesity in elderly humans.

Levels of light pollution (LAN|) have been growing exponentially over the natural nocturnal lighting levels provided by starlight and moonlight in recent years, see Falchi et al (2011). There is real concern that migration from the now widely used sodium lamps to white lamps (MH and LEDs) would produce an increase of pollution in the scotopic and melatonin suppression bands of more than five times the present levels, supposing the same photopic installed flux. This increase will exacerbate known and possible unknown effects of light pollution on human health, environment and on visual perception of the Universe by humans. Kristen et al (2007) first commented on the ability of LAN to disrupt endocrine systems which is of course relevant to both cancer and diabetes. An Pan (2011) showed conclusively that LAN ( in the form of shift work) produces a modestly increased risk of type 2 diabetes in women.

Discussion (wireless technology)

Conflicting evidence exists in the literature much in the same way as it does for cancer association. Groves et al (2001) in a study entitled Cancer in Korean War Navy Technicians: Mortality Survey after 40 Years concluded that there was actually a lower than average diabetes risk in military personnel engaged in work with radar, radio and electronics. The chances are these types of personnel would have been physically fit and on sensible diets which could be sufficient to account for the result. So how does one square this with the notion that there anecdotal reports of increased incidence of diabetes close to mobile phone towers. The answer most probably lies in sleep disruption. See for example, Al-Khlaiwi and Meo (2004), Abdel- Rassoul (2007). Sleep disruption is part of what is known as ‘Microwave Syndrome’ as first described by Navarro et al (2009). The digital modulation schemes which mobile phone and similar systems such as TETRA have pulse repetition frequencies which are close to those of human brain waves and doubtless this accentuates the problem of sleep disturbance.

Discussion ( other facets of modern living)

Pyko et al (2014) have showed in a significantly large epidemiological study that traffic noise increases central ( waistline) obesity.

http://oem.bmj.com/content/early/2015/04/28/oemed-2014-102516.short?rss=1. An open access study (2012) paper http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001230 has shown an almost direct correlation between waist size and type 2 diabetes risk irrespective of BMI provided BMI<35. Hence increased traffic noise, particularly at night ought to be an indicator for type 2 diabetes. To test this hypothesis we should perhaps look at the all night pub opening act which became law in November 2005. This would have caused an attendant increase in night noise and ought to have caused a corresponding increase in diabetes. Interesting data for Scotland is available in the public domain. The step change increase between 2005 and 2006 of approximately 40,000 newly diagnosed cases is approximately double that of the preceding years and in strong support of the hypothesis.

A more general and ongoing additional noise source is that of wind turbines. Those advocates of wind turbine safety would suggest that wind turbine noise is not a danger to human health and as local phenomenon only affects people very close to wind turbines and wind farms. However, it has recently been shown that infrasound from wind farms can permeate as far as 60 km under certain atmospheric conditions. Barnes (2013) has shown this to be associated in space and time with the sleep disturbing phenomena known as the Hum. It is interesting to note that new diabetes cases in Scotland almost doubled between 2001 and 2005 an era which also saw the doubling of installed inland windfarm rated power capacity.

It would appear we have another possible candidate besides statins for the increase in diabetes incidence. A significant amount of additional research will be required to assess the number of people exposed to statins and those exposed to windfarm infrasound and both to uncover the full and true picture.

The USA

A significant test of the LAN hypothesis is to consider LAN and type 2 diabetes in the USA. Here we have an even larger target group to support statistical association. Comparison of the two geographic distribution data sets are therefore instructive.

There appears to be correlation but perhaps not as significant as in the UK. For example one can see that as LAN in the USA generally increases from west to east with the exception of the Californian coast so does diabetes incidence. The differences are thought to lie in climate, race and socioeconomic class and I will discuss the former two elsewhere. With regard to socio economic class there are studies which suggest that the lower the class, the greater the risk. For example May et al ( 2005) found that socioeconomic disadvantage, especially with low educational attainment, is a significant predictor of incident Type 2 diabetes. Robbins et al (2001) found that Diabetes prevalence is strongly associated with PIR ( poverty income ratio ) especially in women. This effect is clear to see in the above geographic distributions. For example if one looks in the extreme north east corner of the USA, LAN is minimal but the further north east one goes diabetes incidence increases from on average 22% to 27% following a corresponding fall in average family income from $47,000 to less than $35,000. A similar effect can be seen across the South Western band of the USA whereas income rises diabetes incidence falls from in excess of 30% down to as low as 20%.

Conclusions

The hypothesis that LAN and sleep disturbances due to night noise and possibly even mobile phone emissions may at least in part be responsible for the recent increases in type 2 diabetes is supported in data from the UK and Scotland and to some extent also those data from the USA. In the latter the situation is more complex and socioeconomic factors are also at work.

Further work.

Further work is required on the effects of statins and windfarms, this will require considerable effort. Further work is needed to consider the effects of climate/sunshine levels/ vitamin D status and race on the prevalence of type 2 diabetes. The author has conducted and published online similar work on various cancer epidemiology and would hope to proceed fairly quickly and publish in the very near future on these aspects.