European Journal of Pediatrics

, Volume 176, Issue 6, pp 713–722 | Cite as

Alcohol and cigarette use among adolescents with type 1 diabetes

  • Anna M HogendorfEmail author
  • Wojciech Fendler
  • Janusz Sierosławski
  • Katarzyna Bobeff
  • Krzysztof Węgrewicz
  • Kamila I Malewska
  • Maciej W Przudzik
  • Małgorzata Szmigiero-Kawko
  • Beata Sztangierska
  • Małgorzata Myśliwiec
  • Agnieszka Szadkowska
  • Wojciech M Młynarski
Original Article


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).

Conclusions: Although alcohol and cigarette consumption is lower than in controls, it is common among teenagers with type 1 diabetes, effecting metabolic control and causing the risk of acute diabetes complications. Better prevention strategies should be implemented in this group of patients in their early teen years.

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.


Alcohol 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


Authors’ contributions

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.

Ethical approval

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

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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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Anna M Hogendorf
    • 1
    Email author
  • Wojciech Fendler
    • 1
  • Janusz Sierosławski
    • 2
  • Katarzyna Bobeff
    • 3
  • Krzysztof Węgrewicz
    • 3
  • Kamila I Malewska
    • 3
  • Maciej W Przudzik
    • 3
  • Małgorzata Szmigiero-Kawko
    • 4
  • Beata Sztangierska
    • 4
  • Małgorzata Myśliwiec
    • 4
  • Agnieszka Szadkowska
    • 1
  • Wojciech M Młynarski
    • 1
  1. 1.Department of Pediatrics, Oncology, Hematology and DiabetologyMedical University of LodzLodzPoland
  2. 2.Department of Studies on Alcoholism and Other DependenciesInstitute of Psychiatry and NeurologyWarsawPoland
  3. 3.Students’ Scientific Circle at the Department of Pediatrics, Oncology, Hematology and DiabetologyMedical University of LodzLodzPoland
  4. 4.Department of Pediatrics, Diabetology and EndocrinologyMedical University of GdanskGdanskPoland

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