Relationship between smoking and quantity with diabetic complications in type 2 diabetes mellitus patients

Year 2019, Volume: 44 Issue: 1, 110 - 117, 31.03.2019

Yusuf Kayar , Hüseyin Çetin Mehmet Ağın

https://doi.org/10.17826/cumj.412649

Abstract

Purpose: The aim of this study is to investigate the relationship between smoking and diabetic complications in diabetes-mellitus patients.

Materials and Methods: This study included 757 patients followed-up with type-2 diabetes-mellitus. Demographic anthropometric characteristics, diabetic complications, cigarette smoking and smoking amount were included in the study. The relationship between smoking and diabetic complications were investigated.

Results: All of the patients, 54.8%(415-patients) were smoking, 12%(91-patients) quit smoking and 33.2%(251-patients) were still smoking. There were statistically significant relationship between smoking and amount of smoking with male gender, waist circumference, HbA1c level, lifestyle, drug compliance, hypertension and diabetic complications. 

Conclusion: There were significant relationship between the cigarette smoking and amount of cigarette smoking with macrovascular and microvascular complications in type-2 diabetes-mellitus patients. Smoking is the most important modifiable risk factor in diabetic patients. For this reason, all members of the diabetes team (physicians, nurses, dieticians, and psychologists) should recommend to quit smoking at every opportunity and persistently.

Keywords

Diabetes mellitus, smoking, quantity

Tip 2 diyabetes mellitus hastalarında sigara içiciliği ve miktarı ile diyabetik komplikasyonlar arasındaki ilişkisi

Abstract

Amaç: Bu çalışmanın amacı diyabetes mellitus hastalarında sigara içiciliği ile diyabetik komplikasyonlar arasındaki ilişkiyi incelemektir.

Gereç ve Yöntem: Bu çalışmaya tip 2 diyabetes mellitus tanısı ile takip edilen 757 hasta dahil edildi. Hastaların demografik antropometrik özellikleri, diyabetik komplikasyonlar ve sigara içiciliği ile birlikte içilen sigara miktarı dökümante edildi. Sigara içiciliği ile diyabetik komplikasyonlar arasındaki ilişki irdelendi. 

Bulgular: Hastaların %54.8’i (415 hasta) sigara içmezken %12’si (91 hasta) sigarayı bırakmış ve %33.2’si de (251 hasta) hala sigara içmekte idi. Sigara içiciliği ile erkek cinsiyet, bel çevresi, HbA1c düzeyi, yaşam biçimi, ilaç uyumu, hipertansiyon ve diyabetik komplikasyonlar arasında anlamlı ilişki saptandı. İçilen sigara miktarı ile erkek cinsiyet, HbA1c düzeyi, bel çevresi, yaşam biçimi, ilaç uyumu ve diyabetik komplikasyonlar arasında anlamlı ilişki saptandı.

Sonuç: Çalışmamızda Tip 2 diyabetes mellitus hastalarında hem sigara içiciliğinin hem de içilen sigara miktarının fazla olması ile makrovasküler ve mikrovasküler komplikasyonlar arasında anlamlı ilişki olduğu görüldü. Diyabetik hastalarda sigara, en önemli değiştirilebilir risk faktörüdür. Bu nedenle diyabet ekibinin tüm üyeleri (hekim, hemşire, diyetisyen ve psikolog) diyabetli hastalara sigarayı bırakmalarını her fırsatta ve ısrarla tavsiye etmeli, destek vermelidir. 

Keywords

Diyabetes mellitus, sigara içiciliği

References

• 1. Satman İ, İmamoğlu Ş, Yılmaz C, Akalın S ve Diabetes Mellitus Çalışma ve Eğitim Grubu. TEMD Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu, 5. Baskı. Bayt Matbaacılık, Ankara, 2011.
• 2. Hilton DJ, OÕRourke PK, Welborn TA and Reid CM. Diabetes detection in Australian general practise: a comparison of diagnostic criteria. Med J Aust 2002;176: 104-7.
• 3. The TURDEP Group. Population-Based Study of Diabetes and Risk Characteristics in Turkey. Diabetes Care 2002; 25(9):1551-6.
• 4. Satman I and the TURDEP Group. Population-Based Study of Diabetes and Risk Characteristics in Turkey. 32. Türkiye Endokrinoloji ve Metabolizma Hastalıkları Kongresi özet kitabı,13-17 Ekim 2010, Antalya, 2010, p.24-9
• 5. Menzin J, Langley-Hawthor C, Friedman M, Boulanger L, Cavanaugh R. Potential short-term economic benefits of improved glycemic control: a managed care perspective. Diabetes Care 2001;24(1):51-5
• 6. International Expert Committee. International Expert Committee report on the role of the A1c assay in the diagnosis of diabetes. Diabetes Care 2009;32:1327–34.
• 7. WHO Report on the Global Tobacco Epidemic, MPOWER, WHO, 2008
• 8. Global Adult Tobacco Survey, Turkey Report, Ministry of Health, Publ. 2 July 2010.
• 9. Carlsson S, Midthjell K, Grill V. Smoking is associated with an increased risk of type 2 diabetes but a decreased risk of autoimmune diabetes in adults: an 11-year follow-up of incidence of diabetes in the Nord-Trondelag study. Diabetologia 2004;47:1953–6.
• 10. Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 2007;298:2654–64.
• 11. Smith U, Axelsen M, Carvalho E, Eliasson B, Jansson PA, Wesslau C. Insulin signaling and action in fat cells: associations with insulin resistance and type 2 diabetes. Ann N Y Acad Sci 1999; 892:119–26.
• 12. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care 2015;38:8-67
• 13. Summary of Revisions for the 2009 Clinical Practice Recommendations. Diabetes Care 2009;32:754.
• 14. Yoshikawa H, Hellstrom-Lindahl E, Grill V. Evidence for functional nicotinic receptors on pancreatic beta cells. Metabolism 2005;54:247–54.
• 15. Bruin JE, Gerstein HC, Morrison KM, Holloway AC. Increased pancreatic beta-cell apoptosis following fetal and neonatal exposure to nicotine is mediated via the mitochondria. Toxicol Sci 2008;103:362−70.
• 16. Chakkarwar VA. Smoking in diabetic nephropathy: sparks in the fuel tank?. World J Diabetes 2012 Dec 15;3(12):186-95
• 17. Halimi JM, Giraudeau B, Vol S, Cacès E, Nivet H, Lebranchu Y, et al. Effects of current smoking and smoking discontinuation on renal function and proteinuria in the general population. Kidney Int. 2000 Sep;58(3):1285-92
• 18. Zheng Y, He M, Congdon N. The worldwide epidemic of diabetic retinopathy. Indian J Ophthalmol. 2012;60(5):428–31
• 19. Boretsky A, Gupta P, Tirgan N, Liu R, Godley BF, Zhang W, et al. Nicotine Accelerates Diabetes-Induced Retinal Changes Curr Eye Res. 2015 April;40(4):368–77.
• 20. Hu R, Zhang XX, Wang WQ, Lau CP, Tse HF. Smoking, homocysteine and degree of arteriolar retinopathy. Atherosclerosis 2005;183(1):95-100.
• 21. Clair C, Cohen MJ, Eichler F, Selby KJ, Rigotti NA. The Effect of Cigarette Smoking on Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis. J Gen Intern Med 2015 Aug;30(8):1193-203
• 22. Mitchell BD, Hawthorne VM, Vinik AI. Cigarette smoking and neuropathy in diabetic patients. Diabetes Care 1990 Apr;13(4):434-7.
• 23. Phipps MS, Jastreboff AM, Furie K, Kernan WN. The diagnosis and management of cerebrovascular disease in diabetes. Curr Diab Rep 2012 Jun;12(3):314-23
• 24. Yusuf S, Reddy S, Ôunpuu S, Anand S. Global Burden of Cardiovascular Diseases: Part I: General Considerations, the Epidemiologic Transition, Risk Factors, and Impact of Urbanization. Circulation 2001;104:2746-53
• 25. Tighe CB, Oakley WS Jr. The prevalence of a diabetic condition and adhesive capsulitis of the shoulder. South Med J 2008;101:591-5.
• 26. Thomas SJ, McDougall C, Brown ID, Jaberoo MC, Stearns A, Ashraf R, et al. Prevalence of symptoms and signs of shoulder problems in people with diabetes mellitus. J Shoulder Elbow Surg 2007;16:748-51