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Rauchen, Alkohol und Diabetes mellitus (Update 2019)

  • Helmut BrathEmail author
  • Susanne Kaser
  • Christian Tatschl
  • Peter Fasching
leitlinien für die praxis
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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.

Schlüsselwörter

Rauchen Passivrauchen Alkohol Diabetes mellitus 

Smoking, alcohol and diabetes (Update 2019)

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.

Keywords

Smoking Second Hand Smoke Alcohol Diabetes mellitus 

Notes

Interessenkonflikt

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

Literatur

  1. 1.
    GBD 2015 Tobacco Collaborators: Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet. 2017 May 13;389(10082):1885–1906Google Scholar
  2. 2.
    Öberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011;8;377(9760):139–46. Jan.CrossRefGoogle Scholar
  3. 3.
    Hackshaw A, Morris JK, Boniface S, Tang JL, Milenković D. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ. 2018;24;360:j5855. Jan.CrossRefGoogle Scholar
  4. 4.
    Ng M, Freeman MK, Fleming TD, Robinson M, Dwyer-Lindgren L, Thomson B, Wollum A, Sanman E, Wulf S, Lopez AD, Murray CJ, Gakidou E. Smoking prevalence and cigarette consumption in 187 countries, 1980–2012. JAMA. 2014;8;311(2):183–92. Jan.CrossRefGoogle Scholar
  5. 5.
    Clair C, Meigs JB, Rigotti NA. Relationships of cotinine and self-reported cigarette smoking with hemoglobin A1c in the U.S.: results from the National Health and Nutrition Examination Survey, 1999–2008. Diabetes Care. 2011;34(10):2250–5. Oct.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Pan A, Wang Y, Talaei M, Hu FB, Wu T. Relation of active, passive, and quitting smoking with incident type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015;3(12):958–67. Dec.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Carter BD, Freedman ND, Jacobs EJ. Smoking and mortality—beyond established causes. N Engl J Med. 2015;28;372(22):2170. May.Google Scholar
  8. 8.
    Kowall B, Rathmann W, Strassburger K, Heier M, Holle R, Thorand B, Giani G, Peters A, Meisinger C. Association of passive & active smoking with incident type 2 diabetes in the elderly population: the KORA S4/F5 cohort study. Eur J Epidemiol. 2010;25(6):393–402. Jun.CrossRefPubMedGoogle Scholar
  9. 9.
    Wei X. E M, Yu S: A meta-analysis of passive smoking and risk of developing T2DM. Diabetes Res Clin Pract. 2015;107(1):9–14. Jan.CrossRefPubMedGoogle Scholar
  10. 10.
    Orth SR, Schroeder T, Ritz E, Ferrari P. Effects of smoking on renal function in patients with type 1 and type 2 diabetes mellitus. Nephrol Dial Transplant. 2005;20(11):2414–9. Nov.CrossRefPubMedGoogle Scholar
  11. 11.
    Pan A, Wang Y, Talaei M, Hu FB. Relation of Smoking With Total Mortality and Cardiovascular Events Among Patients With Diabetes Mellitus A Meta-Analysis and Systematic Review. Circulation. 2015;132:1795–804.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Rawshani A, Rawshani A, Franzén S, Sattar N, Eliasson B, Svensson AM, Zethelius B, Miftaraj M, McGuire DK, Rosengren A, Gudbjörnsdottir S. Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2018;16;379(7):633–44. Aug.CrossRefGoogle Scholar
  13. 13.
    Aubin HJ, Farley A, Lycett D, Lahmek P, Aveyard P. Weight gain in smokers after quitting cigarettes: meta-analysis. BMJ. IEEE Trans Med Imaging. 2012;10;345:e4439. Jul.Google Scholar
  14. 14.
    Hu Y, Zong G, Liu G, Wang M, Rosner B, Pan A, Willett WC, Manson JE, Hu FB, Sun Q. Smoking Cessation, Weight Change, Type 2 Diabetes, and Mortality. N Engl J Med. 2018;16;379(7):623–32. Aug.CrossRefGoogle Scholar
  15. 15.
    Schumann A, Rumpf HJ, Meyer C, et al. Deutsche Version des Fagerström-Test for Nicotine Dependence (FTND-G) und des Heaviness of Smoking Index (HSI-G). In: Rist A, Rist F, Küfner H, Hrsg. Elektronisches Handbuch zu Erhebungsinstrumenten im Suchtbereich (EHES). Version, Bd. 3. Zentrum für Umfragen, MethodenundAnalysen: Glöckner; 2003. 00 Mannheim.Google Scholar
  16. 16.
    Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2007, Issue 4. Art.no.: CD000146. Last update: November 01. 2007Google Scholar
  17. 17.
    Anthenelli RM, Benowitz NL, West R, Aubin StL. McRae T, Lawrence D, Ascher J, Russ C, Krishen A, Evins AE. Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. Lancet. 2016;18;387(10037):2507–20. Jun.CrossRefGoogle Scholar
  18. 18.
    Tonstad S, Lawrence D. Varenicline in smokers with diabetes: A pooled analysis of 15 randomized, placebo-controlled studies of varenicline. J Diabetes Investig. 2017;8(1):93–100. Jan.CrossRefPubMedGoogle Scholar
  19. 19.
    Kivimäki M, Vahtera J, Tabák AG, Halonen JI, Vineis P, Pentti J, Pahkala K, Rovio S, Viikari J, Kähönen M, Juonala M, Ferrie JE, Stringhini S, Raitakari OT. Neighbourhood socioeconomic disadvantage, risk factors, and diabetes from childhood to middle age in the Young Finns Study: a cohort study. Lancet. Public Health. 2018;3(8):e365–e73.PubMedGoogle Scholar
  20. 20.
    Nanayakkara N, Pease A, Ranasinha S, Wischer N, Andrikopoulos S, Speight J, de Courten B. Zoungas S Depression and diabetes distress in adults with type 2 diabetes: results from the Australian National Diabetes Audit (ANDA) 2016. Sci Rep. 2018;18;8(1):7846. May.CrossRefGoogle Scholar
  21. 21.
    Clyde M, Smith KJ, Gariépy G, Schmitz N. Assessing the longitudinal associations and stability of smoking and depression syndrome over a 4-year period in a community sample with type 2 diabetes. J Diabetes. 2015;7(1):95–101. Jan.CrossRefPubMedGoogle Scholar
  22. 22.
    Tanasescu M, Hu FB, Willet WC, et al. Alcohol consumption and risk of coronary heart disease among men with type 2 diabetes mellitusl. J Am Col Cardiol. 2001;38:1836–42.CrossRefGoogle Scholar
  23. 23.
    Huang Y, Li Y, Zheng S et al. Moderate alcohol consumption and atherosclerosis: meta-analysis of effects on lipids and inflammation. Wien Klin Wochenschr 2017; 129: 835–843. Doi:10.1007/s00508-017-1235-6CrossRefPubMedGoogle Scholar
  24. 24.
    American Diabetes Association. Lifestyle management: standards of medical care in diabetes-2018. Diabetes Care 2018; 41 (Suppl.1): S38–S50. Doi.org/10.2337/dc18-S004Google Scholar
  25. 25.
    Kerr WC, Ye Y, Williams E et al. Lifetime alcohol use patterns and risk of diabetes onset in the National Alcohol Survey. Alcohol Clin Exp Res 2018, Nov 13.  https://doi.org/10.1111/acer.13924 (Epub ahead of print)
  26. 26.
    Macdonald H. The case for calling alcohol a drug. BMJ 2018; 363:k4370.  https://doi.org/10.1136/bmj.k4370 (published online first 18 October 2018)
  27. 27.
    GBD 2016 Alcohol Collaborators.Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2018; 392: 1015–1035. Doi.org/10.1016/S0140-6736(18)31310-2 (published online August 23, 2018)Google Scholar
  28. 28.
    Jiang H, et al. Temporal associations of alcohol and tobacco consumption with cancer mortality. Jama Netw Open. 2018;1(3):e180713.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Garaycoechea I, et al. Alcohol and endogenous aldehydes damage chromosomes and mutate stem cells. Nature. 2018;553:171–6.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Niskanen L., Partonen T, Auvinen A et al. Excess mortality in Finnish diabetic subjects due to alcohol, accidents and suicide: a nationwide study. Eur J Endocrinology 2018; 179: 299–306. Doi.org/10.1530/EJE-18-0351Google Scholar
  31. 31.
    Fuster D, Samet JH. Alcohol use in patients with chronic liver disease. N Engl J Med 2018; 379: 1251–1261.  https://doi.org/10.1056/NEJMra1715733 CrossRefPubMedGoogle Scholar
  32. 32.
    Chao AM, Wadden TA, Tronieri TA et al. Alcohol intake and weight loss during intensive lifestyle intervention for adults with overweight or obesity and diabetes. Obesity 2018, published online Dec. 2018.  https://doi.org/10.1002/oby.22316 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Helmut Brath
    • 1
    Email author
  • Susanne Kaser
    • 2
    • 3
  • Christian Tatschl
    • 4
  • Peter Fasching
    • 5
  1. 1.Diabetes- und FettstoffwechselambulanzGesundheitszentrum Wien-SüdWienÖsterreich
  2. 2.Department für Innere Medizin IMedizinische Universität InnsbruckInnsbruckÖsterreich
  3. 3.Christian Doppler Labor für InsulinresistenzMedizinische Universität InnsbruckInnsbruckÖsterreich
  4. 4.The Telic Nutshell. Gesundheitskommunikation mit Sinn e.U.WienÖsterreich
  5. 5.5. Medizinische Abteilung für Endokrinologie, Rheumatologie und AkutgeriatrieWilhelminenspital der Stadt WienWienÖsterreich

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