Climate Change and Diabetes: A Growing Public Health Intersection

Diabetes mellitus is a complex chronic disease affecting over 500 million people globally expected to rise to 783 million by 2045. In the U.S. alone, nearly 30 million adults have been diagnosed with diabetes, and more than one-third of adults live with prediabetes, placing them at high risk for developing type 2 diabetes. In recognition of World Diabetes Day, we spoke with Associate Professor Iris Padilla, PhD, MBA, MSN, APRN, FNP-BC, FAANP, whose recent publication in The Journal for Nurse Practitioners with colleague Valerie K. Sabol, PhD, MBA, ACNP-BC, GNP-BC, ANEF, FAANP, FAAN explores the growing connection between climate change and type 2 diabetes (T2D). Their work highlights how environmental stressors—from extreme heat to food insecurity—are compounding risks for people living with diabetes, and how nurse practitioners (NPs) are uniquely positioned to respond.

What inspired you to explore the link between climate change and type 2 diabetes?

My interest stems from both clinical experience and emerging evidence that environmental factors meaningfully influence metabolic health. People living with diabetes are particularly vulnerable to climate-related stressors, including extreme heat, reduced air quality, food insecurity, and disruptions in medication access during weather-related emergencies.

Why is it important to understand this link?

These exposures can worsen blood sugar control and increase cardiometabolic risk (which refers to the combined likelihood of developing conditions like heart disease, stroke, and type 2 diabetes) especially in communities already facing health disparities. Understanding this intersection helps us anticipate patient needs, strengthen community resilience, and develop proactive strategies to protect at-risk populations. Ultimately, it supports more equitable, sustainable, and patient-centered approaches to chronic disease management in a changing climate.

You’ve said nurse practitioners are uniquely positioned to address this issue. Can you explain why?

Nurse practitioners are often embedded in the communities they serve and take a holistic view of patient care. We’re not just treating symptoms, we’re looking at the full picture, including social and environmental factors that affect health. This makes us well-equipped to educate patients, advocate for healthier environments, and lead initiatives that address both chronic disease and climate resilience. Our role allows us to bridge clinical care with public health and policy in meaningful ways.

What can be done at a community level to help address these challenges?

At the community level, expanding access to walkable neighborhoods, bike lanes, and green spaces encourages physical activity, lowers cardiovascular risk, and reduces greenhouse gas emissions. Supporting sustainable, plant-forward food systems improves nutrition security while decreasing the environmental impact of industrial agriculture, addressing two major drivers of T2D: poor diet and limited access to healthy foods.

By plant-forward, I mean food systems that prioritize the production and consumption of plant-based foods—like vegetables, fruits, whole grains, legumes, and nuts—while reducing reliance on animal-based and ultra-processed foods. This doesn’t mean eliminating animal products entirely, but shifting the balance toward more sustainable, nutrient-dense options. These systems help lower carbon emissions, improve dietary quality, and make healthy foods more accessible, especially in underserved communities.

What about at a clinical or policy level?

From a clinical perspective, we need stronger emergency preparedness for medication access, refrigeration needs, and power-dependent diabetes technology during climate-related disasters. Decarbonizing healthcare operations—through energy efficiency, waste reduction, and supply-chain innovation—not only lowers emissions but also reduces costs, allowing us to reinvest in preventive care. Policies that prioritize resilient communities, equitable food access, and sustainable healthcare delivery can create healthier environments for people living with diabetes while addressing the root causes of climate change.