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Diabetic Control and Smoking. - Christopher Laylan Student, UW-Madison Madison, WI  - Rodney Erickson, MD Mayo Clinic Health System-Tomah Tomah, WI  -Richard Erickson, MS Texas Tech University Lubbock, TX. Introduction.

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Diabetic control and smoking

Diabetic Control and Smoking

- Christopher Laylan

Student, UW-Madison

Madison, WI 

- Rodney Erickson, MD

Mayo Clinic Health System-Tomah

Tomah, WI 

-Richard Erickson, MS

Texas Tech University

Lubbock, TX


Introduction
Introduction

  • Tobacco use and diabetes are risk factors for the development and progression of atherosclerotic vascular disease and the associated increase in morbidity and mortality

  • Diabetes on the increase

    • Expected to raise 165% by 2050 (6)

  • Smoking is on the decline…right?

    • Yes, among the general population

    • No, among age group 18-24 (8)

      • Smoking at this age leads to more smoking in future (8)

      • However, smoking at this age is partly due to “social smoking”


Earlier studies
Earlier Studies

  • Smoking accelerates onset of diabetes mellitus (1)

    • meta-analysis in 2007 reported that smokers had a 1.4 higher relative risk of developing diabetes compared to nonsmokers.

  • 1995 European study found smokers had higher average glycosolatedhemoglobins (A1C) than non-smokers for those with Type 1 diabetes.

  • No reports of the effect of tobacco use on glycemic control among those diagnosed with Type II diabetes


Our study
Our study

  • Our study looks at the relationship between tobacco use and glycemic control among patients with diabetes, type 1 and 2.

    • Do diabetics who smoke have worse glycemic control?


Why??

  • Physiological

    • Smoking raises blood glucose (7)

  • Socio-Economical Position (SEP)

    • People of lower SEP more likely to smoke (3)

      • Less exercise (5)

      • Poor eating habits due to decreased knowledge (6)

      • Less health care


Methods
Methods

  • Accessed diabetic patient records from 5 clinics in Wisconsin

    • Total of 1,963 charts

  • Observed 4 tests for determining diabetic control of smokers and non-smokers

    • Hba1c (main test we observed)

    • Blood Pressure

    • LDL

    • Aspirin use


Methods cont d
Methods (Cont’d)

  • Test standards

    • Hba1c greater than or equal to 8%

    • BP < 140 / 90 mmHGg

    • LDL < 100 dL

    • Aspirin use = yes or no


Results
Results

  • Hba1c Results

    • non-smokers: mean of 7.27%

      • Total of 1,606

    • smokers: mean of 7.56%

      • Total of 349

  • BP Results

    • Non-Smoker

      • High = 357 (22.5%)

      • Low = 1,231 (77.5%)

    • Smoker

      • High = 111 (31.8%)

      • Low = 238 (68.2%)


Results cont d
Results (cont’d)

  • LDL Results

    • Total of 1,866

    • Non-Smokers

      • High = 264 (17.2%)

      • Low = 1,268 (82.8%)

    • Smokers

      • High = 105 (32.5%)

      • Low = 218 (67.5%)

  • Aspirin Result

    • Total of 1,890

    • Non-Smokers

      • no = 67 (4.3%)

      • yes = 1,485 (95.7%)

    • Smokers

      • No = 19 (5.6%)

      • Yes = 318 (94.4%)




Conclusion
Conclusion

  • This study shows that diabetic nicotine users are 1.4 times more likely to have Hba1c values greater than the goal of 8% compared to diabetic non-nicotine users.

    • This study needs to confirmed on larger number of clinics


Bibliography
Bibliography

  • (1) Will, JC. (2000, September 05). Cigarette smoking and diabetes mellitus; evidence of a positive association from a large prospective cohort study. Retrieved from http://ije.oxfordjournals.org/content/30/3/540.full.pdf+html

  • (2) Power, C. (2004, October 28). The contribution of childhood and adult socioeconomic position to adult obesity and smoking behaviour: an international comparison. Retrieved from http://ije.oxfordjournals.org/content/34/2/335.short

  • (3) Lantz, PM, PhD. (1998, June 03).Socioeconomic factors, health behaviors, and mortality results from a nationally representative prospective study of us adults. Retrieved from http://jama.ama-assn.org/content/279/21/1703.full.pdf+html

  • (4) Boule, MG, MA. (2001, September 12).Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus. Retrieved from http://jama.ama-assn.org/content/286/10/1218.short

  • (5) Conway, TL, Ph.D. (1992, November).Smoking, exercise, and physical fitness. Retrieved from http://www.sciencedirect.com/science/article/pii/009174359290079W

  • (6) Boyle, JP, PhD. (2001, November).Projection of diabetes burden through 2050 impact of changing demography and disease prevalence in the u.s.. Retrieved from http://care.diabetesjournals.org/content/24/11/1936.short

  • (7) Wechsler, H, PhD. (1998, November 18).Increased levels of cigarette use among college students a cause for national concern. Retrieved from http://jama.ama-assn.org/content/280/19/1673.full.pdf+html

  • (8) Moran, S, MD, MSCE. (2004, October 01).Social smoking among us college students . Retrieved from http://pediatrics.aappublications.org/content/114/4/1028.full

  • (9) Wikstrom, K. (2010, November 18). Socio-economic differences in dysglycemia and lifestyle-related risk factors in the finnish middle-aged population. Retrieved from http://eurpub.oxfordjournals.org/content/early/2010/11/18/eurpub.ckq164.abstract

  • (10) Smith, BT. (2011, January 17). Life-course socioeconomic position and type 2 diabetes mellitus the framingham offspring study. Retrieved from http://aje.oxfordjournals.org/content/173/4/438.abstract

  • (11) Zhang, L, MD. (2011, February 25).Association between passive and active smoking and incident type 2 diabetes in women. Retrieved from http://care.diabetesjournals.org/content/34/4/892.abstract


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