Tobacco use in diabetes mellitus : a retrospective cohort study to determine the effect of snuff tobacco use on diabetes mellitus complications over a period of nine years

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dc.contributor.author Ally, Raihaan M.
dc.contributor.author Van Zyl, Danie G.
dc.date.accessioned 2024-08-30T09:52:41Z
dc.date.available 2024-08-30T09:52:41Z
dc.date.issued 2024
dc.description.abstract BACKGROUND : Diabetes mellitus (DM) affects millions of people worldwide, with associated morbidity and premature mortality exacerbated by all forms of smoking. The effects of smokeless tobacco, such as snuff and chewing tobacco, have not been well researched. The use of these products is on the increase and is an important public health issue. OBJECTIVES : The objective is to assess the difference between snuff tobacco use and non-tobacco use with regard to all-cause mortality, diabetic nephropathy (DN), and diabetic retinopathy (DR) over a nine-year period. METHODS : The records of 1 241 patients were assessed at the diabetic clinic at Kalafong Provincial Tertiary Hospital. Patient data extracted from the database included demographic information, clinical observations, and laboratory data. All data regarding changes in tobacco use were extracted. Survival analyses were done using Kaplan–Meier analysis with log-rank tests to assess the relationship between snuff use and time to the development of diabetes complications and mortality. To adjust for confounders such as diabetic control and duration, as well as systolic hypertension, Cox proportional hazards modelling was done with the same outcome measures. RESULTS : Of the 1 241, 120 patients died, representing a natural all-cause mortality of 9.7%. There was no statistically significant difference between snuff users and non-snuff users with regard to all-cause mortality after adjustment for age, smoking, and diastolic blood pressure. The HR for snuff use was 1.116 (CI = 0.603–2.064) (p = 0.726) after adjustment for age (HR 1.042, CI 1.026-1.058, p < 0.001), smoking (HR 1.66, CI = 1.126–2.447, p = 0.01), and diastolic blood pressure (HR 1.014, CI 1.004–1.025, p = 0.007). CONCLUSION : This study could not demonstrate any additional risk to all-cause mortality, diabetic nephropathy, or diabetic retinopathy due to the use of snuff in diabetic patients. en_US
dc.description.department Internal Medicine en_US
dc.description.librarian hj2024 en_US
dc.description.sdg SDG-03:Good heatlh and well-being en_US
dc.description.uri https://www.tandfonline.com/loi/oemd20 en_US
dc.identifier.citation Ally, R.M. & Van Zyl, D. 2024, 'Tobacco use in diabetes mellitus: a retrospective cohort study to determine the effect of snuff tobacco use on diabetes mellitus complications over a period of nine years', Journal of Endocrinology, Metabolism and Diabetes of South Africa, vol. 29, no. 1, pp. 18-23, doi : 10.1080/16089677.2023.2246767. en_US
dc.identifier.issn 1608-9677 (print)
dc.identifier.issn 2220-1009 (online)
dc.identifier.other 10.1080/16089677.2023.2246767
dc.identifier.uri http://hdl.handle.net/2263/97941
dc.language.iso en en_US
dc.publisher NISC (Pty) Ltd, Medpharm Publications, and Informa UK Limited en_US
dc.rights © 2023 The Author(s). Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0]. en_US
dc.subject Diabetes mellitus en_US
dc.subject Diabetic retinopathy en_US
dc.subject Diabetic nephropathy en_US
dc.subject Tobacco en_US
dc.subject Smoking en_US
dc.subject Snuff en_US
dc.subject Smokeless tobacco en_US
dc.subject SDG-03: Good health and well-being en_US
dc.title Tobacco use in diabetes mellitus : a retrospective cohort study to determine the effect of snuff tobacco use on diabetes mellitus complications over a period of nine years en_US
dc.type Article en_US


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