The Association Between Passive Smoking and Type 2 Diabetes

Zhu, Bo; Wu, Xiaohua; Wang, Xin; Zheng, Qi; Sun, Guifan

doi:10.1177/1010539514531041

Cited by 23 publications

(18 citation statements)

References 29 publications

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“…Additionally, the findings of the meta-analysis are consistent with those of two other systematic reviews. Both Wang et al [5], which pooled the findings of four cohort studies with an overall sample of 112,351 subjects, and Zhu et al [6], which included 14 studies, came up to similar conclusions.…”

supporting

confidence: 50%

Passive smoke exposure and type-2 diabetes: is it time for action?

Faggiano

Allara

2014

Endocrine

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In a recent meta-analysis [1] of six cohort studies, Sun et al. found evidence of a 21 % increased risk of type-2 diabetes or glucose intolerance among subjects exposed to passive smoking (95 % CI 7-38 %) compared to those who were not exposed. The authors conclude that such association may have a 'far-reaching significance' for public health. At a first glance, such conclusion might be justified. The metaanalysis appears to have good methodological quality, including an adequately powered pooled sample size (n = 154,406) and using a random effects model to address between study heterogeneity.Association, however, does not necessarily imply causation. Findings might be due to alternative explanations, although the large pooled sample size minimises the risk for random error. First, since the studies included in the meta-analysis are observational, passive smoking exposure could mask the effect of other causal factors of diabetes such as being overweight or obese, diet habits, and family history-and adjustments performed in individual studies may have still left considerable residual confounding. Second, assessment of the exposure could be biased and overestimated among those with diabetes due to lack of blinding of the assessors.

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supporting

confidence: 50%

Passive smoke exposure and type-2 diabetes: is it time for action?

Faggiano

Allara

2014

Endocrine

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“…However, the HR estimates remained similar after we removed these comorbidities from the multivariate models. On the other hand, there is possibility that we under-adjusted for potential confounders since we did not have data on variables such as physical activity, dietary intake, and smoking, which may be associated with both diabetes and survival 44–46 . Finally, there might be incomplete information and inaccurate coding in our data that are typical in medical records data.…”

Section: Discussionmentioning

confidence: 99%

Diabetes and Overall Survival among Breast Cancer Patients in the U.S. Military Health System

Shao

Gill

Zahm³

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background While research suggests that type 2 diabetes mellitus (DM-2) is associated with overall and breast cancer-specific decreased survival, most prior studies of breast cancer survival investigated the effect of pre-existing DM-2 without assessing the effect of DM-2 diagnosed at or after breast cancer diagnosis. This study examined the relationship between DM-2 diagnosed before and after breast cancer diagnosis and overall survival. Methods This study uses linked Department of Defense cancer registry and medical claims data from 9,398 women diagnosed with breast cancer between 1998 and 2007. Cox proportional hazards models were used to assess the association between DM-2 and overall survival. Results Our analyses showed that women with DM-2 diagnosed before breast cancer diagnosis tended to have a higher risk of mortality compared to women without diabetes (HR=1.17, 95% CI=0.95-1.44) after adjustment for potential confounders. Similarly, patients diagnosed with DM-2 at or after breast cancer diagnosis had increased mortality compared with women without DM-2 (HR= 1.39, 95% CI= 1.16-1.66). The similar tendency was also observed among most subgroups when results were stratified by race, menopausal status, obesity, tumor hormone receptor status, and stage. Conclusions Using data from a health system that provides universal healthcare to its beneficiaries, this study showed an increased risk of death associated with DM-2, regardless of whether it was diagnosed before or at/after breast cancer diagnosis. Impact: These results suggest the potential effects of factors independent of the timing of DM-2 clinical diagnosis on the association of DM-2 with overall survival.

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“…Smoking is the most commonly known risk factor for diabetes [1]. In 2010, the world prevalence of diabetes among adults (age 20–79 years) was 6.4%, affecting 285 million adults; it is predicted to increase to 7.7%, and 439 million adults by 2030.…”

Section: Introductionmentioning

confidence: 99%

Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study

Kim

Noh

Choi³

et al. 2017

IJERPH

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Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.

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The Association Between Passive Smoking and Type 2 Diabetes

Cited by 23 publications

References 29 publications

Passive smoke exposure and type-2 diabetes: is it time for action?

Passive smoke exposure and type-2 diabetes: is it time for action?

Diabetes and Overall Survival among Breast Cancer Patients in the U.S. Military Health System

Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study

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