Alcohol and cigarette use among adolescents with type 1 diabetes
In this study, we compare the prevalence of alcohol and cigarette use among Polish adolescents with type 1 diabetes mellitus (T1DM) (n = 209), aged 15–18 years, with that of a large cohort of their healthy peers, using standardized questionnaire used in the European School Survey Project on Alcohol and Drugs (ESPAD). The lifetime, previous year, and past 30-day prevalence of alcohol consumption was high among adolescents with T1DM but lower than in the controls (82.8 vs 92.0%, 71.7 vs 85.6%, and 47.5 vs 69.7%, respectively, p < 10−5). The lifetime and 30-day prevalence of cigarette use was also lower among patients than the controls (54.6 vs 65.5%, p = 0.001 and 27.3 vs 35.9%, p = 0.012, respectively). Patients who admitted smoking exhibited worse metabolic control than non-smokers (p < 0.0001) and had a higher chance of developing diabetic ketoacidosis. The incidence of severe hypoglycemia was higher among those who reported getting drunk in the previous 30 days (p = 0.04) and lifetime smoking (p = 0.01).
What is Known:
• Substance use remains a significant cause of morbidity and mortality among teenagers with type 1 diabetes.
• Current medical literature contains inconsistent data on the prevalence of alcohol and cigarette use among adolescents with type 1 diabetes, mostly due to methodological problems with conducting such surveys.
What is New:
• Methodological approach: we used a validated questionnaire from the European School Survey Project on Alcohol and Other Drugs (ESPAD) and compared the results to a large national control group of 12,114 healthy students who took part in ESPAD in 2011.
KeywordsAlcohol Cigarettes Type 1 diabetes Adolescents Metabolic control
American Diabetes Association
European School Survey Project on Alcohol and Drugs
International Society for Pediatric and Adolescent Diabetes
Type 1 diabetes mellitus
AH, WF and WM had the core idea for this study. JS and AH prepared the questionnaire. KB and WF performed statistical analysis.
All authors either analyzed the data or interpreted the results. AH wrote the draft of the article. All other authors commented on the manuscript.
Compliance with ethical standards
This study was funded by Medical University of Lodz (grant number 503/1-090-01/503-01). The Polish ESPAD 2011 edition was financed by The National Bureau for Drug Prevention and The State Agency for the Prevention of Alcohol-Related Problems (PARPA).
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Bioethics Committee of the Medical University of Lodz approved the study.
Informed consent was obtained from all individual participants included in the study.
This article does not contain any studies with animals performed by any of the authors.
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