Endocrine Abstracts

Introduction: Global mean surface air temperatures have risen by about 1 °C in the past century and are projected to increase by another 1–6 °C by 2100 depending on greenhouse gas emissions. As a result of the increase in mean temperatures, heatwaves have become more severe, frequent, and prevalent. Heat exposure in ambient temperature is associated with all-cause diabetes mortality and all-cause hospitalisation in people with diabetes. However, there is a paucity about the current evidence of the association between heat exposure and hospitalisation for hyperglycaemic emergencies, such as diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic state (HHS), and hypoglycaemia. This scoping review aims to map existing literature and provide a summary of diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), and hypoglycaemia and heatwaves in people with diabetes. This includes risk factors, interventions and identification of research gaps in the literature.

Methods: Electronic databases (MEDLINE, EMBASE, and, Global Health) were systematically and independently searched following the Joanna Briggs Institute (JBI) guidelines. Two independent researchers assessed the literature and conducted the review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for Scoping Reviews (PRISMA-ScR). Covidence was used for for title/abstract screening, full-text screening, data extraction, and quality assessment.

Results: Of the 4406 articles screened, 75 articles met inclusion criteria and 12 were included for this scoping review. The majority of studies were cross-sectional concentrated in the Americas, Asia and Australia. The findings indicated that heat exposure was associated with an increased risk of hospitalisations for DKA, HHS but not hypoglycaemia. There was a lack of information regarding other environmental conditions such as humidity, air pollution and extreme weather events which may interact with these outcomes.

Conclusions: People with diabetes face heightened susceptibility to health threats linked to climate change, such as increased heat exposure. This research has the potential to inform proactive measures against the elevated risk of hyperglycaemic emergencies. These findings offer an opportunity for developing public health initiatives aimed at managing heatwaves in the contemporary context of global warming. Implementing policies that acknowledge the interplay between climate change and diabetes outcomes could improve the overall health of the diabetic population. Clearly, further studies are necessary for investigating potential solutions to tackle this crisis