As per the World Health Organization, all but 1% of the world's population is exposed to unhealthy air and also exceeds the WHO limits for pollutants. However, there are some parts of the world where aur quality has improved through policies that limits pollution, while in other parts, it has not reached the desired results.

For US, more than 25% of the population is exposed to "unhealthy" air as per the Environmental Protection Agency (EPA), this is according to the report by the climate non-profit First Street Foundation. By 2050, the number of people exposed to "unhealthy" air will increase by more than half. The worst days of air pollution, reports BBC, "hazardous" or maroon under the EPA's system will rise by 27%.

Why are we talking about this today? It is because of the recent wildfire in California, which started on January 7. This is also one of the factors that is spiking the PM2.5 levels. It has increased by up to five micrograms per cubic metre in the western US in the past decade.

What is PM2.5?

It is a type of air pollution which is made of particulate matter and measures 2.5 micrometres across or less. It is roughly 30 times smaller than the width of a human hair. These particles are made with a mixture of solid and liquid substances, which varies in their chemical composition, including carbon, metals, and organic compounds.

These specks of airborne soot, dust and other substances can also trigger inflammation, which could also damage your brain.

As per a 2021 study titled The Changing risk and burden of wildfire in the United States, a quarter of US's PM2.5 pollution was caused by wildfire smoke. In 2023, US also witnessed a significant dip in air quality and visibility as smoke from wildfires north of the Canadian border entered across the continent. In May 2024, Canada also saw a start to its wildfire season, and one town was evacuated in British Colombia.

Wildfire smoke and its effects

Wildfires do not only affect those who live near forests, peatlands, and grasslands, but also to the cities and environment in general. It can send plumes up to 14 miles or 23km into the stratosphere, and from there, it can spread all over the globe. For instance, in 2023, the Siberian wildfires released smoke that travelled across the Pacific Oceans to reach Alaska and Seattle.

Other than PM2.5, wildfire smoke is also harmful to immune cells in lungs, and the toxicity could be four times greater than particulates from other types of pollution.

Another 2019 study titled Effects of Atmosphere Processing on the Oxidative Potential of Biomass Burning Organic Aerosols found the toxicity of smoke doubled in the hours after it was first emitted and reached four times greater toxicity at its peak.

Health Impact

There have been research that shows how pollution affects your brain. It can lead to impaired judgment, poorer performance in school and even higher levels of crime, as per the 2018 study by the London School of Economics.

Other health concerns include weight gain. There have been researches that links airborne pollution such as PM2.5 to obesity. The studies have found that children who live in most polluted areas are twice as more likely to have obesity. Some studies also find the link of air pollution harming our sense of smell. As per an Italian study from 2022, titled Association between environmental air pollution and olfactory functioning among Italian adolescents and young adults in Northern Italy, noses of teenagers and young adults became less sensitive to odors after being exposed to nitrogen dioxide, which is a component in traffic fumes.

Ramzan, the holiest month in Islam, marked by dawn-to-dusk fasting, poses health risks for people with diabetes. Health experts urge patients to consult their doctors before observing the fast.

Ramzan is a period of intense spiritual reflection, self-discipline, and devotion for Muslims worldwide. During the month-long fasting period, the believers refrain from eating and even drinking (including water), from dawn to sunset.

The faithful eat a modest meal (sehri) before the first light of dawn to provide energy for the day. The fast is broken at sunset, traditionally starting with dates and water, followed by a larger meal (iftar).

According to health experts, for individuals whose diabetes is well controlled, fasting may be possible with proper adjustments.

"Diabetes requires regular monitoring, balanced meals, and timely medication. When eating patterns change during Ramzan, blood glucose levels can fluctuate. That is why I strongly recommend consulting your doctor before you plan to fast,” Dr. Saptarshi Bhattacharya, Senior Consultant, Endocrinology, Indraprastha Apollo Hospitals, told HealthandMe.

The expert advised people not to skip sehri, and to include complex carbohydrates such as whole grains, along with protein like eggs, dal, or curd, and plenty of fluids to help maintain stable glucose levels throughout the day.

At iftar, avoid overeating. Start with light, balanced food and limit fried items, sweets, and sugary drinks, as these can cause a sudden spike in blood glucose, Dr. Bhattacharya said.

Type 2 Diabetes patients with good glycemic control, lifestyle management, or stable oral medications can fast safely.

However, those on multiple insulin doses, with complications, or with poor control are considered moderate to high risk, Dr. Kartik Thakkar, Consultant Medicine, Ruby Hall Clinic, told HealthandMe.

The health expert also noted that most Type 1 diabetes patients are considered high risk, especially those with brittle diabetes, frequent hypoglycemia (low blood sugar), or a history of diabetic ketoacidosis (DKA). Many are medically advised not to fast, particularly if glucose control is unstable.

Children and adolescents with type 1 diabetes are considered high risk and are usually advised against fasting due to the unpredictable nature of insulin requirements.

Who Should Avoid Fasting Altogether?

• People with a history of severe hypoglycemia in the last 3 months;
• Recurrent hypoglycemia;
• Advanced kidney disease;
• Elderly patients with frailty; and
• Pregnant women with diabetes

Dr. Thakkar said that such individuals fall into the very high-risk category and are medically exempt from fasting.

The expert also suggested clinical tests to determine whether a diabetic patient is fit to fast. These include:

• Glycemic control (HbA1c levels)
• Duration of diabetes (long-standing diabetes can increase complication risk)
• Presence of complications (neuropathy, nephropathy, cardiovascular disease)
• Kidney function and hydration status

What Warning Signs Should Prompt Breaking The Fast Immediately?

A diabetic patient must break the fast if:

• Blood glucose <70 mg/dL (3.9 mmol/L)
• Blood glucose >300 mg/dL (16.7 mmol/L)
• Severe dizziness or fainting
• Confusion or blurred vision
• Persistent vomiting
• Symptoms of dehydration (extreme thirst, very low urine output)
• Chest pain or breathlessness

A new study has shown that people who survived COVID-19 infections are more likely to develop obstructive sleep apnea (OSA) for years after the infection with the SARS-CoV-2 virus.

OSA is a common and serious sleep disorder that causes the throat muscles to relax and block the airway, resulting in fragmented, nonrestorative sleep, low blood oxygen, and loud snoring.

The February 2026 study, published on the preprint server medRxiv, found that people with both severe and non-severe COVID infections are at higher risk of developing sleep apnea and other sleep issues for 4.5 years.

"SARS-CoV-2 infection is independently associated with increased risk of new-onset OSA. These findings support targeted screening in post-COVID populations,” said Sagar Changela, Department of Radiology, Albert Einstein College of Medicine, in the paper.

What The Study Found

Although an infection with the SARS-CoV-2 virus has been associated with long-term respiratory and neurological conditions, its role in new-onset OSA remains unclear.

The retrospective study, which has not been peer-reviewed, involved 910,393 patients. The results showed that patients hospitalized due to COVID were 41 percent at risk of new onset of OSA.

One-third of people with mild COVID infection, who weren't hospitalized, also suffered from sleep issues.

The researchers also linked OSA to cardiovascular, metabolic, and cognitive morbidity. The team found that OSA increased the risk of heart failure and pulmonary hypertension among hospitalized COVID patients, compared to those with mild infections.

On the other hand, the non-hospitalized COVID patients were significantly more likely than controls to develop obesity.

Further analyses showed that the risk of new-onset OSA was higher in hospitalized COVID patients with asthma and those who were younger than 60 years. Notably, women were also found at greater risk than men, while vaccination status did not vary by risk.

According to the team of researchers, the major factors for OSA among COVID patients are low-grade systemic inflammation after a SARS-CoV-2 infection that reduces upper-airway neuromuscular control.

In addition, the higher levels of inflammatory cytokines often seen in long-COVID patients can also affect respiratory drive and upper-airway stability -- key factors for OSA.

What Is Sleep Apnea?

Sleep apnea is a serious sleep disorder where a person's airway can collapse completely or partially. It causes breathing lapses during sleep, and the body stops breathing many times while an individual is asleep. It also weakens throat muscles, leading to airway collapse during sleep. The decrease in oxygen saturation can also lead to death.

While OSA is the most common type of the sleep disorder, other types include central sleep apnea and complex sleep apnea.

Obesity is the major cause of this disorder, and loud snoring is the most common symptom. The person suffering from the condition feels tired, even after getting adequate sleep.

Treating sleep apnea is key to preventing long-term health complications such as cardiovascular disease, hypertension, diabetes, stroke, and increased mortality.

CPAP machines, oral appliances, and lifestyle modifications are common and effective treatment measures.

For decades, diabetes conversations have revolved around diet, weight and genetics. While these remain central, growing medical evidence shows two often ignored factors play a powerful biological role in blood sugar control: stress and sleep.

Dr Narendra BS, Lead Consultant in Endocrinology and Diabetology at Aster Whitefield, Bengaluru, recently wrote for NDTV explaining that these are not minor lifestyle irritants but metabolic triggers.

According to him, poor sleep and chronic stress “create a biological environment that puts us at risk for developing type 2 diabetes or make it harder to control blood sugar if we already have the condition.”

How Stress Raises Blood Sugar

When the body senses danger, it activates its major stress systems including the hypothalamic pituitary adrenal axis and the sympathetic nervous system. These release cortisol and adrenaline, hormones designed to help survival.

They rapidly increase blood glucose so the body has instant energy. This is useful during emergencies but harmful when stress becomes constant.

“Continuous stress from work pressure, caregiving or anxiety reduces the body’s insulin sensitivity,” Dr Narendra explains. Over time, cells stop responding properly to insulin and glucose levels rise.

Long term studies now link persistent stress patterns to insulin resistance and a higher risk of diabetes. In simple terms, even if diet remains unchanged, chronic emotional strain can gradually push the body toward metabolic disease.

The Hidden Damage From Poor Sleep

Sleep disturbance works just as strongly against blood sugar regulation.

Sleep restriction, irregular schedules and fragmented sleep impair glucose tolerance, sometimes within days. Research shows that even partial sleep loss raises fasting glucose and insulin levels. Over time, this increases HbA1c and diabetes risk.

“When you don’t get good sleep, your body is simply not as efficient at handling sugar,” he notes.

The problem worsens because stress and sleep feed each other. Stress disrupts sleep, sleep deprivation increases stress hormones, and both promote unhealthy habits such as late night snacking, skipping exercise and excess caffeine intake.

Doctors in India increasingly link this cycle to urban lifestyles and rising diabetes prevalence.

Encouragingly, The Damage Can Be Reversed

The positive takeaway is that these effects are modifiable. Improving sleep duration and reducing stress measurably improves insulin sensitivity.

Sleep extension trials have shown improvements in glucose metabolism. Stress management programs have lowered fasting glucose and HbA1c levels.

Because the science is clear, Dr Narendra recommends that diabetes care must include mental and sleep assessment. Screening for insomnia, anxiety and depression should be routine in metabolic clinics.

What Patients Can Do

Sleep should be treated like medicine. Adults should aim for 7 to 8 hours of consistent sleep, maintain fixed bedtimes and avoid screens for at least an hour before bed. Shift workers may require specialist guidance due to circadian rhythm disruption.

Stress management can begin with simple practices. Deep breathing, mindfulness and short cognitive exercises can lower daily cortisol levels. Therapy and medication may help when anxiety or depression is present.

Physical activity is equally important. Regular exercise improves insulin response and prevents excessive stress reactions. Even a short walk after meals helps reduce blood sugar spikes.

A New Approach To Diabetes Care

Healthcare providers are encouraged to actively discuss sleep and psychological health during treatment. A combined approach using lifestyle modification, mental health care and medication provides better results than focusing on diet alone.

“Blood sugar is not just a number on a test,” Dr Narendra emphasizes. “It reflects lifestyle, biology and psychology. Addressing sleep and stress tackles a major but often neglected contributor to poor control.”

In short, managing diabetes is no longer only about what is on the plate. It is also about what happens at night and what weighs on the mind.