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Szwarcbard N, Villani M, Earnest A, Flack J, Andrikopoulos S, Wischer N, Soldatos G, Gasevic D, Zoungas S. The association of smoking status with glycemic control, metabolic profile and diabetic complications- Results of the Australian National Diabetes Audit (ANDA). J Diabetes Complications 2020; 34:107626. [PMID: 32527672 DOI: 10.1016/j.jdiacomp.2020.107626] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Tobacco smoking and diabetes mellitus contribute significantly to the overall health burden and mortality of Australians. We aimed to assess the relationship of smoking with glycemic control, metabolic profile and complications in Australian patients living with diabetes. METHODS We analysed the 2011-2017 biennial Australian National Diabetes Audit cross-sectional data. Patients were classified as current, past or never smokers. Linear (or quantile) and logistic regression models were used to assess for associations. RESULTS Data from 15,352 patients were analysed, including 72.2% with type 2 diabetes. Current smokers comprised 13.5% of the study population. Current and past smokers had a median HbA1c that was 0.49% and 0.14% higher than never smokers, respectively, as well as higher triglyceride and lower HDL levels (all p values < .0001). Compared to never smokers, current smokers had higher odds of severe hypoglycemia and current and past smokers had higher odds of myocardial infarction, stroke, peripheral vascular disease, lower limb amputation, erectile dysfunction and peripheral neuropathy (all p values ≤.001), with no significant change over time. CONCLUSION When compared to never smokers, current and past smokers had poorer glycemic and lipid control and higher odds of macrovascular and microvascular complications. Despite this, current smoking remains prevalent among Australians with diabetes.
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Affiliation(s)
- N Szwarcbard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - M Villani
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia; Research and Evaluation, Ambulance Victoria, Blackburn, VIC 3130, Australia
| | - A Earnest
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - J Flack
- Department of Diabetes and Endocrinology, Bankstown-Lidcombe Hospital, Bankstown, NSW 2200, Australia; Faculty of Medicine, University of New South Wales, Sydney, NSW,Australia; School of Medicine, Western Sydney University, Sydney, NSW,Australia
| | - S Andrikopoulos
- Department of Medicine, University of Melbourne, Parkville, VIC 3010, Australia; Australian Diabetes Society, Sydney, NSW 2000, Australia
| | - N Wischer
- National Association of Diabetes Centres, Sydney, NSW, 2000, Australia
| | - G Soldatos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia; Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC,Australia, 3168
| | - D Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia; Usher Institute, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, United Kingdom
| | - S Zoungas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia; Diabetes and Vascular Medicine Unit, Monash Health, Clayton, VIC,Australia, 3168.
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Nanayakkara N, Pease AJ, Ranasinha S, Wischer N, Andrikopoulos S, de Courten B, Zoungas S. Younger people with Type 2 diabetes have poorer self-care practices compared with older people: results from the Australian National Diabetes Audit. Diabet Med 2018; 35:1087-1095. [PMID: 29729055 DOI: 10.1111/dme.13660] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2018] [Indexed: 11/26/2022]
Abstract
AIM This cross-sectional study compares the self-care practices of younger and older people with Type 2 diabetes. METHODS Data were analysed from the Australian National Diabetes Audit (ANDA) including 2552 adults with Type 2 diabetes from Australian Diabetes Centres. Pre-specified demographic and clinical variables were obtained. Self-care variables (physical activity, following dietary recommendations, medication adherence and monitoring blood glucose levels) were compared in people ≤ 64 and > 64 years of age. RESULTS Mean age (± sd) of participants was 63 ± 13 years overall, 53 ± 9 years for the younger group and 73 ± 6 years for the older group. A greater proportion of younger people had HbA1c levels > 53 mmol/mol (> 7.0%) (76% vs. 68%), reported difficulty following dietary recommendations (50% vs. 32%) and forgetting medications (37% vs. 22%) compared with older people (all P-values <0.001). A smaller proportion of younger compared with older people reported monitoring their blood glucose levels as often as recommended (60% vs. 70%, P < 0.001). Similar proportions of people aged ≤ 64 and > 64 years required insulin therapy (59% vs. 57%, P = 0.200). Younger age was associated with a twofold increase in the odds of not following the recommended self-care practices after adjustment for gender, smoking, insulin therapy, depression and allied health attendance (all P < 0.001). CONCLUSIONS Despite shorter diabetes duration, younger age was associated with worse glycaemic control and poorer diabetes self-care practices among people with Type 2 diabetes. Targeted strategies are required to optimize diabetes self-care practices and thereby glycaemic control.
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Affiliation(s)
- N Nanayakkara
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia
| | - A J Pease
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia
| | - S Ranasinha
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - N Wischer
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- National Association Diabetes Centres, Sydney, Australia
| | - S Andrikopoulos
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- National Association Diabetes Centres, Sydney, Australia
| | - B de Courten
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia
| | - S Zoungas
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia
- The George Institute for Global Health, Camperdown, New South Wales, Australia
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