Environmental factors in the development of diabetes mellitus.

Diabetes mellitus is a global health issue, with a multifactorial pathogenesis. The increasing prevalence of diabetes requires a careful assessment of risk factors for an adequate preventive strategy. Recently, a great interest has been focused on the environmental factors associated with the onset of the disease, from the best known lifestyle factors, such as diet and physical activity, to environmental pollution and gut microbiome. It is now evident that epigenetic modulation has a pivotal role in determining the phenotype of genetically predisposed individuals in response to environmental factors. Epigenetic changes can occur both in utero and after birth, influencing the onset of chronic diseases, such as diabetes mellitus, in adulthood. Indeed, it has been demonstrated that these new actors in diabetes pathogenesis could represent promising therapeutic targets. Therefore, major efforts are needed to achieve a better understanding of the risk factors influencing the pathogenesis of the disease in order to allow better treatment and prevention strategies. © Springer Nature Switzerland AG 2022.