Effective Type 2 Diabetes Management Can Reduce Societal Greenhouse Gas Emissions

Effective type 2 diabetes (T2D) prevention, treatment, and management through early implementation of evidence-based guidelines can not only improve patient outcomes but also reduce health care-related environmental impacts and limit greenhouse gas (GHG) emissions. The new research, published in Diabetes and Endocrinology, details the vast societal benefits related to prompt diagnosis and optimal care for adults with prediabetes or T2D.^1,2

“In our paper, we demonstrate that the prevention of diabetes, in this case, not progressing from prediabetes to diabetes, leads to longer life expectancy,” Niels Lund, MSc, vice president of Changing Diabetes at Novo Nordisk and lead investigator of the study, said in an interview with Pharmacy Times. “What is new here is that we can also estimate that T2D prevention could more than halve the carbon footprint linked to those disease complications.”

The study is part of an extensive collaboration with the Sustainable Markets Initiative, which seeks to facilitate sustainability, research new efforts to conserve the world’s resources, and reduce the world’s emission production. Lund and his investigative team utilized a core diabetes model from IQVIA, adapted to replace cost inputs with GHG associated with medical interventions and procedures for the management of T2D and its complications.^2,3

A total of 1000 patients were included in the simulation. The goal was to simulate how specific scenarios of diabetes treatment could reduce GHG emissions emitted from the health care industry, which Lund noted accounts for more emissions than the aviation industry.^2,3

Preventing Diabetes From Developing Can Conserve the Environment

Investigators first assessed the impacts of preventing progression of prediabetes to T2D. This prevention improved undiscounted life years (LYs; 6.357) and quality-adjusted life years (QALYs; 3.747) compared with natural progression. Furthermore, patients who remained prediabetic exhibited lower diabetes-related complication or event rates compared with patients who progressed naturally to T2D.^1,2

Total GHG emissions associated with the care of individuals with prediabetes who did not progress further to T2D were approximately 67% less compared with those who naturally progressed to T2D. This was driven primarily by the reduced need for managing diabetes-related complications, mainly cardiovascular disease (35.8%), renal disease (97.6%), and eye diseases (73.3%) over a lifetime, in addition to avoiding overall T2D treatment (88.4%).¹

For the average patient with well-controlled T2D, improved LYs and QALYs were similarly observed; these individuals had a lower risk of developing diabetes-related events compared with uncontrolled T2D. Caring for patients with well-controlled T2D was linked to 21% less GHG emissions compared with uncontrolled patients. Reductions were mainly due to a lack of management of renal (44.9%), CVD (20.4%), and eye diseases (24.1%).¹

Considerations for Health Systems

If effective therapy for T2D was delayed by 2 or 5 years, not only were undiscounted LYs reduced, but GHG emissions over a lifetime associated with well-controlled T2D increased, with higher emissions the longer the delay. However, even with delays in treatment, GHG emissions were less for well-controlled T2D compared with uncontrolled T2D, highlighting the positive benefits of treatment even if it is considered late in the disease course.^1,2

This should demonstrate to pharmacists that even if a patient presents with uncontrolled diabetes at one point, utilizing effective treatment strategies to reduce the burden of disease as soon as possible can still make a meaningful difference.^1,2

“Our study shows that it’s important to keep a tight grip on the parameters that you can control,” Lund explained. “The paper also underlines the importance of keeping your numbers in check: keeping your blood sugar levels low, keeping blood pressure in check, and ensuring that lipids are low.”^1,2

Lund said that pharmacists can contribute to patient counseling and education regarding the importance of lifestyle and diet adjustments, in conjunction with proper T2D treatment strategies. He also discussed that significant reductions in long-term macrovascular complications—such as heart failure, stroke, and kidney disease—not only improved outcomes and mortality rates for patients but reduced emissions produced across health systems. In turn, this saves health systems valuable physical and financial resources, allowing for better care across indications.^1,2

Quoting Benjamin Franklin, Lund said that “an ounce of prevention is worth a pound of cure.” ^1,2

“Translated to diabetes and improved care, it suggests that early investments and efforts pay off in the long run, both for patients, health systems, and, as we’ve documented, also for the planet,” Lund concluded.^1,2

REFERENCES

1. Lund N, Maslova E, Chen J, et al. Assessment of greenhouse gas emission of type 2 diabetes management in adults: A modeling study in the UK. BMJ Open. 2026;16€:106299. doi:10.1136/bmjopen-2025-106299

2. Type 2 diabetes prevention could more than halve carbon footprint linked to disease complications. News Release. BMJ Group. EurekAlert!. Released January 20, 2026. Accessed February 13, 2026.

3. Dutchen S. Confronting health care’s carbon footprint. Harvard Medicine. Published November 2023. Accessed February 13, 2026.