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Rauchen, Alkohol und Diabetes mellitus (Update 2019)

Smoking, alcohol and diabetes (Update 2019)

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Zusammenfassung

Rauchen und Passivrauchen erhöhen Diabetesinzidenz und Wahrscheinlichkeit für Spätschäden deutlich. Rauchstopp kann zu Gewichtszunahme und erhöhtem Diabetesrisiko führen, senkt aber trotzdem kardiovaskuläre und Gesamtmortalität. Eine Basisdiagnostik (Fagerström-Test, exhalatorisches CO) ist die Grundlage einer erfolgreichen Raucherentwöhnung. An medikamentöser Unterstützung stehen Varenicline, Nikotinersatztherapie und Bupropion zur Verfügung. Sozioökonomische und psychische Faktoren spielen für Rauchen und Rauchstopp eine wichtige Rolle.

Moderater Alkoholkonsum senkt möglicherweise Diabetes- und kardiovaskuläres Risiko. Selektionsbias und falsche Angaben könnten in Studien allerdings diese Wirkungen zu optimistisch erscheinen lassen. Dem steht ein dosisabhängiges Mehr an Krankheit und gesundheitlich eingeschränkten Lebensjahren gegenüber, v. a. durch Krebs, Lebererkrankungen und Infektionen.

Summary

Smoking and second-hand smoke strongly increase incidence of diabetes and probability for its complications. Smoking cessation can lead to weight gain and increased diabetes risk; however, it decreases cardiovascular and total mortality. A basal diagnostics (Fagerström Test, exhaled CO) is the basis for successful smoking cessation. Supporting medication include Varenicline, Nicotine Replacement Therapy and Bupropion. Socio-economic as well as psychological factors play an important role for smoking and smoking cessation.

Moderate consumption of alcohol possibly decreases risk for diabetes and cardiovascular diseases. Selection bias and underreporting in studies maybe contribute to a too optimistic view. On the other hand, alcohol increases in a dose dependant fashion excess morbidity and disability adjusted life years, especially by cancer, liver diseases and infections.

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Authors and Affiliations

  1. Diabetes- und Fettstoffwechselambulanz, Gesundheitszentrum Wien-Süd, Wienerbergstraße 13, 1100, Wien, Österreich

    Helmut Brath

  2. Department für Innere Medizin I, Medizinische Universität Innsbruck, Innsbruck, Österreich

    Susanne Kaser

  3. Christian Doppler Labor für Insulinresistenz, Medizinische Universität Innsbruck, Innsbruck, Österreich

    Susanne Kaser

  4. The Telic Nutshell. Gesundheitskommunikation mit Sinn e.U., Wien, Österreich

    Christian Tatschl

  5. 5. Medizinische Abteilung für Endokrinologie, Rheumatologie und Akutgeriatrie, Wilhelminenspital der Stadt Wien, Wien, Österreich

    Peter Fasching

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  1. Helmut Brath
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Correspondence to Helmut Brath.

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H. Brath hat von Pfizer Vortragshonorare erhalten. S. Kaser, C. Tatschl und P. Fasching geben an, dass kein Interessenkonflikt besteht.

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Brath, H., Kaser, S., Tatschl, C. et al. Rauchen, Alkohol und Diabetes mellitus (Update 2019). Wien Klin Wochenschr 131 (Suppl 1), 67–70 (2019). https://doi.org/10.1007/s00508-019-1455-z

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