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Han DW, Jung W, Lee KN, Han K, Lee SW, Shin DW. Smoking behavior change and the risk of pneumonia hospitalization among smokers with diabetes mellitus. Sci Rep 2023; 13:14189. [PMID: 37648711 PMCID: PMC10469177 DOI: 10.1038/s41598-023-40658-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023] Open
Abstract
Smoking patients with diabetes mellitus (DM) are at greater risk of developing pneumonia. How smoking behavior changes affect the risk of pneumonia hospitalization, however, remains unclear. Therefore, we investigated the association between smoking behavior change and the risk of pneumonia hospitalization in patients with DM. From January 1, 2009 and December 31, 2018, we investigated the association between smoking behavior change and the risk of pneumonia hospitalization in patients with DM. A total of 332,798 adult patients with DM from the Korean National Health Insurance System database who underwent health screening examination between 2009 and 2012, and were smokers at the first health examination were included. During a mean follow-up of 4.89 years, 14,598 (4.39%) incident pneumonia hospitalization cases were identified. Reducers had a slightly increased risk of pneumonia hospitalization (aHR 1.06, 95% CI 1.01-1.10) compared to sustainers. Quitters did not have a significant association with incidence of pneumonia hospitalization. However, increasers had 13% higher risk of pneumonia hospitalization (aHR 1.13, 95% CI 1.07-1.18), regardless of whether initial smoking was light, moderate, or heavy. Our study showed that an increase in smoking intensity was associated with an increased risk of pneumonia hospitalization in people with DM. However, a protective effect of smoking reduction or cessation on pneumonia risk was not demonstrated.
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Affiliation(s)
- Dong-Woo Han
- Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Wonyoung Jung
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyu Na Lee
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Sei Won Lee
- Department of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology (SAIHST), Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
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Ghit A. Pneumococcal vaccination in diabetic patients: review from clinical practice. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2023. [DOI: 10.1186/s43162-023-00202-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
AbstractThe Middle East and North Africa (MENA) region has the second-highest rate of increase in diabetes, especially in KSA, Egypt, and UAE. Diabetes accounts for a significant economic burden in terms of the cost of treatment, the management of complications, disability, and the loss of productivity. Diabetic adults have an increased susceptibility to infections due to the presence of hyperglycemia. The risk of pneumonia is higher in patients with diabetes. Pneumonia caused by Streptococcus pneumoniae (pneumococcal infections) is the most frequent cause of hospitalization in KSA, which also increases the risk of mortality in diabetic patients. The annual planned pilgrimage to Mecca, KSA, is one of the largest frequent religious gatherings globally, and outbreaks of infectious diseases are of great concern. This review will discuss the pneumococcal infection outbreak and prevention in patients with diabetes in KSA. Also, it will gather information discussed by a scientific advisory board held in Riyadh in 2020 covering the current understanding of pneumococcal disease prevention in diabetic patients and recommendations to overcome barriers facing vaccination.
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Guo T, Shen Q, Ouyang X, Guo W, Li J, He W, Yu B, Wu C, Zhou Z, Luo H, Peng H. Clinical Findings in Diabetes Mellitus Patients with COVID-19. J Diabetes Res 2021; 2021:7830136. [PMID: 33506052 PMCID: PMC7811569 DOI: 10.1155/2021/7830136] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/15/2020] [Accepted: 11/25/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUNDS Diabetes mellitus (DM) is one of the most common comorbidities in patients with coronavirus disease (COVID-19). We aim to summarize the clinical features of DM patients with COVID-19 and find out potential factors associated with severe disease. METHODS In this retrospective, single-center study, the medical records of patients with COVID-19 in Changsha, Hunan, China, from January 21, 2020, to February 19, 2020, were reviewed. Epidemiological information, clinical features, and outcomes were compared between DM patients admitted to the intensive care unit (ICU) or not. RESULTS A total of 241 patients confirmed with COVID-19 were enrolled, including 19 DM patients. There were more patients in DM group admitted to the ICU than non-DM group (36.8% vs. 15.8%, P = 0.045). Compared with non-DM group in the ICU, there were more female patients from DM group in the ICU (85.7% vs. 31.4%, P = 0.024). On admission, the mean level of glycated hemoglobin A1c (HbA1c) was higher in the ICU DM patients than that in the non-ICU DM patients (8.5% vs. 7.1%). There were more DM patients with proteinuria in the ICU group than the non-ICU group (57.1% vs. 33.3%). Twelve DM patients (63.2%) changed diabetic therapy during hospitalization, and all DM patients admitted to the ICU used insulin. As of March 14, all 19 DM patients have been discharged, and no death occurred. CONCLUSIONS DM patients with COVID-19 are vulnerable to severe disease, especially for female patients. High levels of HbA1c and proteinuria could be potential risk factors for severe COVID-19 in DM patients. In addition to timely systemic therapy, the control of blood glucose and proper diabetic therapy is essential to improve the prognosis of severe DM patients with COVID-19.
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Affiliation(s)
- Ting Guo
- Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, China
- The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan 410011, China
| | - Qinxue Shen
- Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, China
- The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan 410011, China
| | - Xiaoli Ouyang
- Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, China
- The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan 410011, China
| | - Wei Guo
- Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, China
- The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan 410011, China
| | - Jinhua Li
- Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, China
- The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan 410011, China
| | - Wenlong He
- Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, China
- The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan 410011, China
| | - Bo Yu
- Department of Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
| | - Chenfang Wu
- Department of Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
| | - Zhiguo Zhou
- Department of Respiratory and Critical Care Medicine, The First Hospital of Changsha, Changsha, Hunan 410000, China
| | - Hong Luo
- Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, China
- The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan 410011, China
| | - Hong Peng
- Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, China
- Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, China
- The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan 410011, China
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Ignatova GL, Blinova EV, Antonov VN, Grebneva IV. [Analysis of the impact of vaccination of pneumococcal infection in patients with chronic obstructive pulmonary disease in combination with diabetes]. TERAPEVT ARKH 2019; 91:49-54. [PMID: 32598610 DOI: 10.26442/00403660.2019.11.000424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Indexed: 01/04/2023]
Abstract
AIM The article presents data on the evaluation of the clinical efficacy of using a conjugated pneumococcal vaccine in patients with COPD in combination with 2-type diabetes during a 3-year follow - up period. MATERIALS AND METHODS The study included 309 patients with an isolated course of COPD and in combination with diabetes. The main parameters for evaluating the effectiveness were: the dynamics of clinical symptoms - shortness of breath on the mMRC scale, CAT test, FEV1, the number of exacerbations, hospitalizations, the number of pneumonia, the state of carbohydrate metabolism (HbA1c) and the lipid profile. For vaccine prevention 13-valent conjugated pneumococcal vaccine Prevenar-13 was used. RESULTS AND CONCLUSIONS The use of PСV13 helps to reduce the severity of respiratory symptoms, reduce the number and duration of exacerbations of COPD, reduce the number of pneumonia. Both in isolated course of COPD and in combination with diabetes. Vaccination PCV13 in patients with comorbid course contributes to the compensation of carbohydrate metabolism and improve the lipid profile.
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Affiliation(s)
- G L Ignatova
- South Ural State Medical University Department of Therapy Institute of Additional Professional Education
| | - E V Blinova
- South Ural State Medical University Department of Therapy Institute of Additional Professional Education
| | - V N Antonov
- South Ural State Medical University Department of Therapy Institute of Additional Professional Education
| | - I V Grebneva
- South Ural State Medical University Department of Therapy Institute of Additional Professional Education
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Engelmann J, Manuwald U, Rubach C, Kugler J, Birkenfeld AL, Hanefeld M, Rothe U. Determinants of mortality in patients with type 2 diabetes: a review. Rev Endocr Metab Disord 2016; 17:129-37. [PMID: 27068710 DOI: 10.1007/s11154-016-9349-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
UNLABELLED We aimed to review and summarize the evidence from accomplished trials analyzing factors influencing mortality in patients with T2DM and to provide some recommendations for targets and treatment in the European region. The following databases were searched for relevant trials: PubMed and the Cochrane Library. Of 3.806 citations, 134 trials met our inclusion criteria. RESULTS The reduction in lifetime for 65 + -years-old patients having less than 10 years T2DM amounts to 1.8 years. Having T2DM for more than 10 years lifetime will be reduced by 2.7 years. However, the lifetime shortening factor of T2DM will even be stronger for 40 + -years-old patients at onset. Males will lose 11.6 years of life and 18.6 QUALYs. T2DM among females will reduce life by 14 QUALYs by 22 years. From a statistical point of view, the highest mortality rate will occur in an over 55-years-old European smoking and non-compliant diabetic woman with alcohol abuse living in a rural area with a low level of education and a low socio-economic status. Furthermore, other co-morbidities such as cardiovascular diseases, gout, and depression affect mortality. Additionally, mortality will increase with a BMI over 35 and also with a BMI under 20-25. This refers to the obesity paradox indicating a higher mortality rate among normal weight patients with T2DM compared to overweight patients with T2DM. HbA1c-levels between 6.5 % and 7 % are associated with the lowest impact on mortality.
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Affiliation(s)
- Jana Engelmann
- Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany
| | - Ulf Manuwald
- Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany
| | - Constanze Rubach
- Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany
| | - Joachim Kugler
- Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany
| | - Andreas L Birkenfeld
- Medical Clinic III, University Clinic, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany
- Study Center Prof. Hanefeld, Research for Metabolic Vascular Syndrome, GWT-TUD GmbH, Fiedlerstraße 34, D-01307, Dresden, Germany
| | - Markolf Hanefeld
- Study Center Prof. Hanefeld, Research for Metabolic Vascular Syndrome, GWT-TUD GmbH, Fiedlerstraße 34, D-01307, Dresden, Germany
| | - Ulrike Rothe
- Health Sciences/Public Health, Faculty of Medicine, TUD, Fetscherstraße 74, D-01307, Dresden, Germany.
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