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. 2023 Jan;135(Suppl 1):84-90.
doi: 10.1007/s00508-023-02161-z. Epub 2023 Apr 20.

[Smoking, heated tobacco products, alcohol and diabetes mellitus (update 2023)]

[Article in German]
Helmut Brath  1   2 , Susanne Kaser  3 , Christian Tatschl  4 , Stephanie Fischer-See  5 , Peter Fasching  6
Affiliations

[Smoking, heated tobacco products, alcohol and diabetes mellitus (update 2023)]

[Article in German]
Helmut Brath et al. Wien Klin Wochenschr. 2023 Jan.

Abstract
in English, German

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. Heated tobacco products (like the E‑cigarette) are no healthy alternative to cigarettes and are associated with increased morbidity and mortality.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.

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 mit positiven Studiendaten stehen Varenicline, Nikotinersatztherapie und Bupropion zur Verfügung. Sozioökonomische und psychische Faktoren spielen für Rauchen und Rauchstopp eine wichtige Rolle. Erhitzte Tabakprodukte (wie die E‑Zigarette) sind keine „gesunde“ Alternative zu Zigaretten und ihrerseits mit erhöhter Morbidität und Mortalität assoziiert.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.

Keywords: Alcohol; Diabetes mellitus; Heated Tobacco Products; Second Hand Smoke; Smoking.

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