Smoking Relapse and Type 2 Diabetes Mellitus–Related Emergency Department Visits Among Senior Patients with Diabetes

Abstract

IntroductionQuitting smoking has been proven to benefit smokers with diabetes. However, among older patients with diabetes, the evidence regarding an association between smoking status and the risk of type 2 diabetes mellitus–related emergency department (ED) visits has not been well investigated.MethodsA retrospective cohort study was performed by using the Louisiana State University Health Care Services Division electronic health records from 2009 to 2011. Patients aged 65 years or older with type 2 diabetes and smoking status recorded at least twice in 2010 were selected. Selected patients with diabetes were classified into nonsmokers, former smokers, continuing smokers, and relapsed smokers. Cox proportional hazards regression models were used to estimate the adjusted hazard ratio (aHR) of 1-year type 2 diabetes–related ED visits for each group compared with nonsmokers.ResultsThere were 174 (8.2%) continuing smokers and 77 (3.6%) relapsed smokers in 2,114 patients with diabetes who were studied. Rates of type 2 diabetes–related ED visits were highest in relapsed smokers (28.6%). Compared with nonsmokers, relapsed smokers had a significantly higher risk of type 2 diabetes–related ED visits (aHR = 1.62; 95% confidence interval [CI], 1.04–2.50). After stratifying by sex, a significantly increased risk of type 2 diabetes–related ED visits was shown only in male relapsed smokers (aHR = 2.05; 95% CI, 1.13–3.71) and female continuing smokers (aHR = 1.65; 95% CI, 1.10–2.47) compared with nonsmokers.ConclusionOlder men with diabetes who were relapsed smokers had a higher risk of type 2 diabetes–related ED visits. Future research and clinical practice should focus on these patients and create more effective interventions for smoking cessation and diabetes management.

Tabagismo em idosos

“…TABELA 1 -Artigos incluídos por autores, delineamento, sujeitos envolvidos, nível de evidência, objetivo e principais achados nos artigos incluídos, ano e país de realização da pesquisa. A exemplo das intervenções governamentais -tal como aumento do preço do tabaco -da mesma maneira que a promoção de orientações relacionadas à saúde, promovem uma diminuição do consumo do tabaco, abrangendo os idosos de menor escolaridade, sugerindo um potencial ganho na qualidade de vida desta parcela da população (17). Salientando que, no Brasil, as políticas públicas vêm atuando de forma a proibir o fumo em ambientes fechados, ao mesmo tempo que aumentaram o Imposto sobre Produtos Industrializados, auxiliando na redução da prevalência de indivíduos fumantes (36).…”

Relationship between tobacco and nicotine products use and clinical presentation at the Emergency Department: study protocol

“…This is expected considering the disease burden caused by smoking, which might result in more ED visits for smokers compared to non-smokers. Current smoking as well as smoking relapse were found to be signi cantly associated with ED visits [20][21][22][23][24]. Accessing at ED often re ects the rst or the only contact of patients with the healthcare system, thus, the ED visit represents an opportunity to record smoking and nicotine use patterns.…”