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Tedavi Öncesi Yüksek Nikotin Bağımlılığı Sigarayı Bırakma Sonrası Diyabet Riskini Artırır mı?

Year 2021, Volume: 15 Issue: 2, 244 - 250, 20.06.2021
https://doi.org/10.21763/tjfmpc.776077

Abstract

Amaç: Bu çalışma, tedavi öncesi nikotin bağımlılık düzeyini (NBD) ve sigara bırakma tedavisi sonrası diyabet risk tarama sonuçlarındaki değişimi gözlemlemeyi amaçlamıştır. Gereç ve Yöntemler: Şubat 2019 ile Temmuz 2019 tarihleri arasında sigara bırakma tedavisi için üçüncü basamak bir hastaneye başvuran toplam 527 sigara kullanan gönüllü bu çalışmaya dahil edilmiştir. Önce demografik veriler, Fagerstrom Nikotin Bağımlılığı Testi (FNBT) ve diyabet riskinin taranmasına yönelik Amerikan Diyabet Derneği (ADA) Diyabet Risk Test’ini içeren soru formu katılımcılara uygulanmıştır. 6 ay sonra telefonla ulaşılabilen 279 katılımcının sigara bırakma durumları ve diyabet riskleri yeniden değerlendirilmiştir. Bulgular: Çalışmanın başlangıcında, sigara içenlerin %33,6'sı ağır düzeyde sigara bağımlısı olup, %20,5'inde tip 2 diyabetesmellitus (T2DM) riski saptanmıştır. FNBT skoru ve diyabet risk skoru (p=0,002; r=0,133) ilişkili olsa da, NBD bırakma öncesi T2DM risk varlığında etkili olmamıştır (p=0,08). Tedavi sonrası sigarayı bırakanların (% 25,3) sigara içmeye devam edenlere (% 13,5) göre T2DM riskinin arttığı tespit edilmiştir. Altı aylık takip, sigaraya devam edenlerde diyabet risk oranının sigarayı bırakanların % 46'sı kadar (p = 0,01 OR = 0,46; 0,25-0,86) olduğunu göstermiştir. Sigarayı bırakanlar arasında diyabet riski ile ilişkili tedavi öncesi ağır bağımlılık (% 54,1), hafif (% 13,5) veya orta (% 32,4) bağımlılıktan daha fazla oranda izlenmiştir (p = 0,004). Tedavi öncesi ve sonrası vücut kitle indeksinde (VKİ) anlamlı bir artış olsa da (p <0,001; Z = −10,39), tedavi sonrası sigarayı bırakanlar ile içmeye devam edenlerin VKİ değerleri arasında fark bulunmamıştır (p: 0,58). Hem sigara içenlerin hem de bırakanların benzer yaş ve cinsiyet özelliklerine sahip olduğu görülmüştür (sırasıyla p = 0,64, p = 0,37). Sonuç: Özellikle ağır düzeyde sigara bağımlılığı olanlar, bırakma sonrası dönemde diyabet riskini önlemek için yaşam tarzı değişikliği ile beraber sigara bırakmanın daha akılcı olacağının farkında olmalıdır. Çalışmamız sigara bağımlılığı, sigara bırakma sonrası dönem ve T2DM riski hakkında literature katkı sağlayacaktır.

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References

  • 1. Roderick P, Turner V, Readshaw A, et al. The global prevalence of tobacco use in type 2 diabetes mellitus patients: A systematic review and meta-analysis. Diabetes research and clinical practice 2019;154:52-65.
  • 2. Facchini FS, Hollenbeck CB, Jeppesen J, et al. Insulin resistance and cigarette smoking. Lancet 1992;339(8802):1128-30. doi: 10.1016/0140-6736(92)90730-q [published Online First: 1992/05/09]
  • 3. Akter S, Goto A, Mizoue T. Smoking and the risk of type 2 diabetes in Japan: a systematic review and meta-analysis. Journal of epidemiology 2017;27(12):553-61.
  • 4. Association AD. Summary of Revisions: Standards of Medical Care in Diabetes—2019. Diabetes Care 2019;42(Supplement 1):S4-S6.
  • 5. Tweed JO, Hsia SH, Lutfy K, et al. The endocrine effects of nicotine and cigarette smoke. Trends in Endocrinology & Metabolism 2012;23(7):334-42.
  • 6. Willi C, Bodenmann P, Ghali WA, et al. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. Jama 2007;298(22):2654-64.
  • 7. Bansal N. Prediabetes diagnosis and treatment: A review. World J Diabetes 2015;6(2):296-303. doi: 10.4239/wjd.v6.i2.296 [published Online First: 2015/03/20]
  • 8. Kivelä J, Wikström K, Virtanen E, et al. Obtaining evidence base for the development of Feel4Diabetes intervention to prevent type 2 diabetes–a narrative literature review. BMC Endocrine Disorders 2020;20(1):1-24.
  • 9. Paulweber B, Valensi P, Lindstrom J, et al. A European evidence-based guideline for the prevention of type 2 diabetes. Horm Metab Res 2010;42 Suppl 1(S 01):S3-36. doi: 10.1055/s-0029-1240928 [published Online First: 2010/04/28]
  • 10. Association AD. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care 2019;42(Suppl 1):S13-S28. doi: 10.2337/dc19-S002 [published Online First: 2018/12/19]
  • 11. Uysal MA, Kadakal F, Karsidag C, et al. Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks 2004;52(2):115-21. [published Online First: 2004/07/09]
  • 12. Örsel O, Örsel S, Alpar S, et al. Sigara bırakmada nikotin bağımlılık düzeylerinin tedavi sonuçlarına etkisi. Solunum Hastalıkları 2005;16(3):112-18.
  • 13. Will JC, Galuska DA, Ford ES, et al. Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study. International journal of epidemiology 2001;30(3):540-46.
  • 14. Cosansu G, Celik S, Özcan S, et al. Determining type 2 diabetes risk factors for the adults: A community based study from Turkey. Primary care diabetes 2018;12(5):409-15.
  • 15. Trihandini I. The Relationship between Smoking as a Modifiable Risk Factor and Chronic Complications on Elderly with Type 2 Diabetes Mellitus. Makara Journal of Health Research 2015:8-14.
  • 16. Yeh HC, Duncan BB, Schmidt MI, et al. Smoking, smoking cessation, and risk for type 2 diabetes mellitus: a cohort study. Ann Intern Med. 2010/01/06 ed, 2010:10-7.
  • 17. Liu G, Hu Y, Zong G, et al. Smoking cessation and weight change in relation to cardiovascular disease incidence and mortality in people with type 2 diabetes: a population-based cohort study. The Lancet Diabetes & Endocrinology 2020;8(2):125-33.
  • 18. Yalçın BM, Yalçın E, Ünal M. Sigarayı Bırakan Kişilerin Bir Yıl İçinde Aldıkları Diyet ve Egzersiz Önerilerine Uyumları, Kilo ve Beden Kitle İndekslerindeki Değişiklikler. Addicta: The Turkish Journal on Addictions, 2019;6:335-47.
  • 19. Komiyama M, Wada H, Ura S, et al. Analysis of factors that determine weight gain during smoking cessation therapy. PloS one 2013;8(8):e72010.
  • 20. Oğuz A, Doğan B, Öner C, et al. Üniversite öğrenci ve çalışanlarının diyabet riski ve beslenme alışkanlıklarının değerlendirilmesi. Türkiye Aile Hekimliği Dergisi 2017;21(2):50-55.
  • 21. Hubbard D, Colantonio LD, Tanner RM, et al. Prediabetes and Risk for Cardiovascular Disease by Hypertension Status in Black Adults: The Jackson Heart Study. Diabetes care 2019:dc191074.
  • 22. Federation ID. IDF Clinical Practice Recommendations for managingType 2 Diabetes in Primary Care 2017 [11]. Available from: https://www.idf.org/e-library/guidelines/128-idf-clinical-practice-recommendations-for-managing-type-2-diabetes-in-primary-care.htmlAccess Date: 25/10/2019.
  • 23. Sampson M, Clark A, Bachmann M, et al. Lifestyle Intervention With or Without Lay Volunteers to Prevent Type 2 Diabetes in People With Impaired Fasting Glucose and/or Nondiabetic Hyperglycemia: A Randomized Clinical Trial. JAMA Internal Medicine 2020.

Does a High Pre-Treatment Nicotine Dependence Increase the Post-Cessation Diabetes Risk?

Year 2021, Volume: 15 Issue: 2, 244 - 250, 20.06.2021
https://doi.org/10.21763/tjfmpc.776077

Abstract

Aim:This study aimed to observe the pre-treatment nicotine dependence level (NDL) and the change in diabetes risk screening results during the post-cessation period.Material and Methods: In the current study, 527 current smokers who applied to a tertiary hospital for smoking cessation treatment between February 2019 and July 2019 were included. Firstly, a questionnaire (containing demographic data, the Fagerstrom Nicotine Dependence Test; FTND, and the American Diabetes Association; ADA Diabetes Risk Screening Tool) was applied. In the second stage, smoking cessation status and diabetes risk of 279 patients who could be reached by phone after 6 months were re-evaluated. Results:Based on initial results, 33.6% of nicotine addicts were heavy smokers and 20.5% had type 2 diabetes mellitus (T2DM) risk. Although FNBT score and diabetes risk score (p = 0.002, r = 0.133) were related, NDL was not effective in the presence of T2DM risk before quitting (p = 0.08). Increased post-cessation T2DM risk was detected in quitters (25.3%) versus current smokers (13.5%).Six-month follow-up indicated that the rate of diabetes risk among current smokers was 46% of quitters (p=0.01, OR=0.46;0.25-0.86). The diabetes risk presence related to pre-treatment heavy dependence among quitters (54.1%) was higher than mild (13.5%) or moderate (32.4%) nicotine dependence (p=0.004). Although final BMI was not different between quitters and smokers (p=0,58), there was a significant increase in BMI between baseline and final visits (p<0.001; Z=−10.39). Both current smokers and quitters had similar age and gender demographics (p=0.64, p=0.37, respectively). Conclusion:Particularly heavy smokers might be aware that smoking cessation would be more rational with a lifestyle change to prevent diabetes risk of the post-cessation period. Our study would contribute to knowledge about smoking, post-cessation, and T2DM risk.

References

  • 1. Roderick P, Turner V, Readshaw A, et al. The global prevalence of tobacco use in type 2 diabetes mellitus patients: A systematic review and meta-analysis. Diabetes research and clinical practice 2019;154:52-65.
  • 2. Facchini FS, Hollenbeck CB, Jeppesen J, et al. Insulin resistance and cigarette smoking. Lancet 1992;339(8802):1128-30. doi: 10.1016/0140-6736(92)90730-q [published Online First: 1992/05/09]
  • 3. Akter S, Goto A, Mizoue T. Smoking and the risk of type 2 diabetes in Japan: a systematic review and meta-analysis. Journal of epidemiology 2017;27(12):553-61.
  • 4. Association AD. Summary of Revisions: Standards of Medical Care in Diabetes—2019. Diabetes Care 2019;42(Supplement 1):S4-S6.
  • 5. Tweed JO, Hsia SH, Lutfy K, et al. The endocrine effects of nicotine and cigarette smoke. Trends in Endocrinology & Metabolism 2012;23(7):334-42.
  • 6. Willi C, Bodenmann P, Ghali WA, et al. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. Jama 2007;298(22):2654-64.
  • 7. Bansal N. Prediabetes diagnosis and treatment: A review. World J Diabetes 2015;6(2):296-303. doi: 10.4239/wjd.v6.i2.296 [published Online First: 2015/03/20]
  • 8. Kivelä J, Wikström K, Virtanen E, et al. Obtaining evidence base for the development of Feel4Diabetes intervention to prevent type 2 diabetes–a narrative literature review. BMC Endocrine Disorders 2020;20(1):1-24.
  • 9. Paulweber B, Valensi P, Lindstrom J, et al. A European evidence-based guideline for the prevention of type 2 diabetes. Horm Metab Res 2010;42 Suppl 1(S 01):S3-36. doi: 10.1055/s-0029-1240928 [published Online First: 2010/04/28]
  • 10. Association AD. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care 2019;42(Suppl 1):S13-S28. doi: 10.2337/dc19-S002 [published Online First: 2018/12/19]
  • 11. Uysal MA, Kadakal F, Karsidag C, et al. Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks 2004;52(2):115-21. [published Online First: 2004/07/09]
  • 12. Örsel O, Örsel S, Alpar S, et al. Sigara bırakmada nikotin bağımlılık düzeylerinin tedavi sonuçlarına etkisi. Solunum Hastalıkları 2005;16(3):112-18.
  • 13. Will JC, Galuska DA, Ford ES, et al. Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study. International journal of epidemiology 2001;30(3):540-46.
  • 14. Cosansu G, Celik S, Özcan S, et al. Determining type 2 diabetes risk factors for the adults: A community based study from Turkey. Primary care diabetes 2018;12(5):409-15.
  • 15. Trihandini I. The Relationship between Smoking as a Modifiable Risk Factor and Chronic Complications on Elderly with Type 2 Diabetes Mellitus. Makara Journal of Health Research 2015:8-14.
  • 16. Yeh HC, Duncan BB, Schmidt MI, et al. Smoking, smoking cessation, and risk for type 2 diabetes mellitus: a cohort study. Ann Intern Med. 2010/01/06 ed, 2010:10-7.
  • 17. Liu G, Hu Y, Zong G, et al. Smoking cessation and weight change in relation to cardiovascular disease incidence and mortality in people with type 2 diabetes: a population-based cohort study. The Lancet Diabetes & Endocrinology 2020;8(2):125-33.
  • 18. Yalçın BM, Yalçın E, Ünal M. Sigarayı Bırakan Kişilerin Bir Yıl İçinde Aldıkları Diyet ve Egzersiz Önerilerine Uyumları, Kilo ve Beden Kitle İndekslerindeki Değişiklikler. Addicta: The Turkish Journal on Addictions, 2019;6:335-47.
  • 19. Komiyama M, Wada H, Ura S, et al. Analysis of factors that determine weight gain during smoking cessation therapy. PloS one 2013;8(8):e72010.
  • 20. Oğuz A, Doğan B, Öner C, et al. Üniversite öğrenci ve çalışanlarının diyabet riski ve beslenme alışkanlıklarının değerlendirilmesi. Türkiye Aile Hekimliği Dergisi 2017;21(2):50-55.
  • 21. Hubbard D, Colantonio LD, Tanner RM, et al. Prediabetes and Risk for Cardiovascular Disease by Hypertension Status in Black Adults: The Jackson Heart Study. Diabetes care 2019:dc191074.
  • 22. Federation ID. IDF Clinical Practice Recommendations for managingType 2 Diabetes in Primary Care 2017 [11]. Available from: https://www.idf.org/e-library/guidelines/128-idf-clinical-practice-recommendations-for-managing-type-2-diabetes-in-primary-care.htmlAccess Date: 25/10/2019.
  • 23. Sampson M, Clark A, Bachmann M, et al. Lifestyle Intervention With or Without Lay Volunteers to Prevent Type 2 Diabetes in People With Impaired Fasting Glucose and/or Nondiabetic Hyperglycemia: A Randomized Clinical Trial. JAMA Internal Medicine 2020.
There are 23 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Orijinal Articles
Authors

Melike Mercan Başpınar 0000-0003-3183-3438

Okcan Basat 0000-0002-5222-9136

Publication Date June 20, 2021
Submission Date July 30, 2020
Published in Issue Year 2021 Volume: 15 Issue: 2

Cite

Vancouver Mercan Başpınar M, Basat O. Does a High Pre-Treatment Nicotine Dependence Increase the Post-Cessation Diabetes Risk?. TJFMPC. 2021;15(2):244-50.

English or Turkish manuscripts from authors with new knowledge to contribute to understanding and improving health and primary care are welcome.