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Cho Y, Park HS, Seo DH, Ahn SH, Hong S, Suh YJ, Chon S, Woo JT, Baik SH, Lee KW, Kim SH. The Association of Smoking Status with Diabetic Microvascular Complications in Korean Patients with Type 2 Diabetes. Yonsei Med J 2024; 65:427-433. [PMID: 39048318 PMCID: PMC11284303 DOI: 10.3349/ymj.2023.0355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 02/16/2024] [Accepted: 03/05/2024] [Indexed: 07/27/2024] Open
Abstract
PURPOSE Few studies have investigated the association between smoking and microvascular complications in the Asian population with type 2 diabetes mellitus (T2DM). We aimed to investigate the relationship between smoking status and microvascular complications in Korean patients with T2DM. MATERIALS AND METHODS From the Korean National Diabetes Program cohort, we included 2316 Korean male with T2DM who had baseline clinical information available, including their smoking status, and underwent diabetic complication studies. RESULTS Compared to non-smokers, current smokers had higher odds of any-microvascular complications [adjusted odds ratio (aOR) 1.45, 95% confidence interval (CI) 1.07-1.97, p=0.016]. The odds of neuropathy were significantly higher; however, the odds of retinopathy were significantly lower in current smokers than in nonsmokers (all p<0.05). Among those who underwent repeated complication tests after 3 years, the risk of newly developed retinopathy was significantly increased in ex-smokers [aOR 3.77 (95% CI 1.61-8.87), p=0.002]. Within ex-smokers, long smoking duration and smoking cessation within the recent 5 years were associated with an increased risk of newly developed retinopathy (all p<0.05). CONCLUSION Male smokers had higher odds of having overall diabetic microvascular complications, including neuropathy. However, the odds of having retinopathy were significantly lower among current smokers. More attention and research are needed regarding the increased risk of retinopathy development in ex-smokers who have recently stopped smoking after a long history of smoking.
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Affiliation(s)
- Yongin Cho
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Hye-Sun Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Da Hea Seo
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seong Hee Ahn
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seongbin Hong
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Young Ju Suh
- Department of Biomedical Sciences, Inha University College of Medicine, Incheon, Korea
| | - Suk Chon
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jeong-Taek Woo
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kwan Woo Lee
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - So Hun Kim
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
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Shrateh ON, Abdelhafez M, Ereqat S, Dein LNE, Iriqat S. Identification of Risk Factors for the Development of Diabetic Retinopathy Among Palestinian Adults With Type 2 Diabetes Mellitus: A Cross-Sectional Study. Endocrinol Diabetes Metab 2024; 7:e494. [PMID: 38874277 PMCID: PMC11177287 DOI: 10.1002/edm2.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/19/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Although risk factors linked to diabetic retinopathy (DR) among patients with Type 2 diabetes mellitus (T2DM) have been extensively studied globally, the specific determinants of these factors in relation to DR in Palestine are presently not well understood. METHODS This retrospective cross-sectional study included patients who underwent DR screening with a fundus camera (VersaCam a). The study included patients aged ≥18 with T2DM, excluding those with other types of diabetes or a history of malignancies. Univariable and multivariable logistic regressions were used to identify factors associated with DR. RESULTS A total of 1163 patients with T2DM were included in this study. Of these, 211 (18.1%) patients were classified in the DR group, 761 (65.4%) in the no DR group and 191 (16.4%) were ungradable. Among the included patients, 434 (37.3%) were male. A secondary level of education or higher and a BMI ≥30 kg/m2, compared with <25 kg/m2, were independently and inversely associated with DR, with odds ratios (ORs) of 0.46 (p < 0.001) and 0.58 (p = 0.046), respectively. A 5-year increase in the duration of T2DM correlated with 45% higher odds of having DR (p < 0.001). Patients with DR were more likely to have HbA1c >7%, be physically inactive and use insulin, with ORs of 1.63 (p = 0.02), 2.05 (p < 0.001) and 1.53 (p = 0.03), respectively. Age, gender, occupational status, hypertension and hyperlipidaemia were not independent predictors of DR (p < 0.05). CONCLUSION Longer duration of T2DM, HbA1c >7%, physical inactivity and insulin use were all independently associated with the presence of DR. Furthermore, a secondary or higher educational level and obesity demonstrated independent and inverse associations with the development of DR.
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Affiliation(s)
- Oadi N Shrateh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammad Abdelhafez
- Department of Internal Medicine, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Suheir Ereqat
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Salam Iriqat
- Ocular Inflammatory Disease Department, St John Eye Hospital, Jerusalem, Palestine
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Walicka M, Krysiński A, La Rosa GRM, Sun A, Campagna D, Di Ciaula A, Dugal T, Kengne A, Le Dinh P, Misra A, Polosa R, Raza SA, Russo C, Sammut R, Somasundaram N. Influence of quitting smoking on diabetes-related complications: A scoping review with a systematic search strategy. Diabetes Metab Syndr 2024; 18:103044. [PMID: 38810420 DOI: 10.1016/j.dsx.2024.103044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION Smoking in people with diabetes markedly elevates their risk of developing complications and increases the likelihood of cardiovascular mortality. This review is the first to specifically provide evidence-based analysis about the influence of quitting smoking on diabetes-related complications in people with type 2 diabetes. METHOD The present review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. All human clinical studies assessing the effects of stopping smoking cessation on diabetes-related complications were included. PubMed and Embase were screened until January 2024. References of primary studies and principal peer-reviewed scientific journals in the field were manually screened. RESULTS We identified a total of 1023 studies. Only 26 met the criteria for eligibility. In general quitting smoking is associated with decreased risks of myocardial infarction and ischemic stroke. Regarding microvascular complications, the strongest evidence for the beneficial effects of smoking cessation is observed in diabetic nephropathy. However, the relationship between smoking cessation and retinopathy, neuropathy, diabetic foot complications and diabetic-related erectile dysfunction, is poorly investigated. CONCLUSION Quitting smoking offers significant advantages in managing diabetes-related complications, significantly lowering the risks of myocardial infarction, ischemic stroke, and diabetic nephropathy. This underscores the importance of cessation. Providing evidence-based information on the benefits of stopping smoking for people with type 2 diabetes who smoke, can bolster smoking cessation efforts in the context of diabetes management.
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Affiliation(s)
- Magdalena Walicka
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland; Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland.
| | - Arkadiusz Krysiński
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland; Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | | | - Ang Sun
- Department of Biology, and Center for Biotechnology/Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, USA
| | - Davide Campagna
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agostino Di Ciaula
- Clinica Medica "A. Murri" Department of Precision and Regenerative Medicine and Ionian Area [DiMePre-J], University "Aldo Moro" Medical School, Bari, Italy
| | - Tabinda Dugal
- Department of Endocrinology College of Physicians and Surgeons, Royal Cornwall Hospital NHS Trust, Truro, UK
| | - Andre Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa; Department of Biological and Environmental Science, Faculty of Science, Walter Sisulu University, Mthatha, South Africa
| | - Phuong Le Dinh
- General Practice, Family Medicine and Check-up Department, FV Hospital Ho Chi Minh City, Viet Nam
| | - Anoop Misra
- Diabetes Foundation [India], New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation [N-DOC], New Delhi, India; Fortis C-DOC Centre for Excellence for Diabetes, Metabolic Disease, and Endocrinology, New Delhi, India
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Center of Excellence for the acceleration of Harm Reduction [CoEHAR], University of Catania, Vietnam, Italy; Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Syed Abbas Raza
- Shaukat Khanum Cancer Hospital and Research Center, Peshawar, Pakistan
| | - Cristina Russo
- Ashford and Saint Peter's Hospitals NHS Foundation Trust, Chertsey, UK
| | - Roberta Sammut
- Department of Nursing, Faculty of Health Sciences, University of Malta, Msida, Malta
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Berlin I, Durlach V, Thomas D, Vergès B, Le Faou AL. Tobacco smoking and diabetes. A comparative survey among diabetologists and smoking cessation specialists. Prim Care Diabetes 2024; 18:241-245. [PMID: 38296760 DOI: 10.1016/j.pcd.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 02/02/2024]
Abstract
AIMS Because tobacco smoking is a major risk factor of mortality in diabetes and guidelines suggest evaluating smoking behavior among individuals with diabetes and helping smokers quit, we aimed to assess knowledge about the tobacco smoking - diabetes relationship among diabetologists and smoking cessation specialists (SCS). METHODS An online cross sectional survey was conceived by the Working Group on Smoking and Diabetes, France. The questionnaire was tested by the members of the Working Group and deemed to be completed in less than 5 min. Only questions receiving the highest number of approval ratings were kept for the survey. The questionnaire was sent to all members of the French Language Society of Diabetes (Société Francophone du Diabète, SFD), N = 969 and the French Language Society on Tobacco (Société Francophone de Tabacologie, SFT), N = 307. The mailing lists of members were obtained with the previous agreement of the societies' board. RESULTS 225 diabetologists and 97 SCS (response rate 23.2% and 31.5%, respectively) completed the questionnaire. Over 90% of the diabetologists reported recording smoking status of their patients. Although diabetologists were aware that smoking increases all-cause mortality of individuals with diabetes, only 29.3% were aware that smoking is a risk factor for type 2 diabetes (76.3% among SCS), for poor glycemic control: 32.9% (86.6% among SCS). Significantly less diabetologists (64%) than SCS (76.3%) were aware of smoking being a risk factor for microangiopathy. More diabetologists considered that smoking cessation is more important than optimizing glycemic control among individuals with type 2 (69.3%) than among those with type 1 diabetes (47.1%). Few diabetologists (11.1%) and SCS (14.4%) reported to be trained for smoking cessation among persons with diabetes. CONCLUSION Specific knowledge about the negative tobacco smoking - diabetes association seems to be insufficient among French diabetologists. Diabetologists but also other health care professionals should be trained to help individuals with diabetes who smoke to quit smoking.
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Affiliation(s)
- Ivan Berlin
- Département de pharmacologie médicale, Hôpital Pitié-Salpêtrière-Sorbonne Université, Paris, France.
| | - Vincent Durlach
- Département Cardio-Thoracique, Université Champagne-Ardenne, UMR CNRS 7369 MEDy, Hôpital Universitaire de Reims, Reims, France
| | - Daniel Thomas
- Institut de cardiologie, Hôpital Pitié-Salpêtrière-Sorbonne Université, Paris, France
| | - Bruno Vergès
- Département d'endocrinologie, diabétologie et maladies métaboliques, Centre Hospitalier de Dijon, INSERM LNC-UMR1231, Université de Bourgogne, Dijon, France
| | - Anne-Laurence Le Faou
- Centre ambulatoire d'addictologie, Hôpital Européen George Pompidou, AP-HP - Centre-Université de Paris Cité, Paris, France
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