Cigarette smoking, alcohol intake and the risk of diabetes mellitus in Gombe State, northeast Nigeria
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Alcohol is consumed in almost all countries worldwide. Heavy drinking can reduce the body’s sensitivity to insulin, which can trigger type 2 diabetes mellitus. Diabetes can complicate chronic pancreatitis, which is overwhelmingly caused by heavy alcohol drinking. Alcohol is also high in calories, with heavy drinkers liable to obesity and a higher risk of type 2 diabetes mellitus. Similarly, cigarette smoking is associated with increased risk of type 2 diabetes mellitus among both middle-aged and elderly men and women. Nigeria is one of the three largest tobacco markets in Africa with a population of almost 13 million smokers. Northeast Nigeria ranks 3rd among the six geopolitical zones, with a smoking rate of 6.1%. In this study, we evaluated the risks of diabetes mellitus associated with alcohol consumption and cigarette smoking in Gombe State, Northeast Nigeria. This cross-sectional survey was conducted in a two-stage cluster sampling scheme based on existing administrative divisions. Study subjects were males and females aged 16 years and older who resided in the Jekadafari Ward of Gombe Metropolis. Subjects were excluded from this study if they were less than 16 years of age, pregnant women or suffered chronic conditions such as chronic kidney disease, chronic liver disease or chronic lung diseases based on clinical history and laboratory results. The calculated sample size was 1600 based on a 3.1% prevalence rate of DM, with a power of 85% and precision of 5%. We obtained complete data on 1302 subjects, of whom 50 (3.8%) had DM. (5.1% in males and 2.86% in females). Alcohol use was prevalent among 365 (28.03%) subjects, and was higher in males (49.4%) compared to females (11.4%). The risk of DM was significantly higher among alcoholusers compared to non-users, with an odds ratio of 4.1 (95%CI: 2.3- 7.3; P=0.0001). Eighty-eight subjects were cigarette smokers, of whom 87 were males and only one was female. We found no significant association between cigarette smoking and DM (OR=0.34, 95%CI 0.05-2.48; P=0.29). The overall prevalence of DM was 3.9%. Alcohol consumption, but not cigarette smoking, was associated with a higher risk of DM in this study.
King H, Zimmet P. Trends in the prevalence and incidence of diabetes: NIDDM World Health Statistics Quarterly. 1988; 41: 190-96.
World Health Organization. Global report on Diabtes. WHO Geneva 2017: http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf
WHO. Global status report on alcohol and health 2014. Accessed July 2017. Available from: http://www.who.int/substance_abuse/publications/global_alcohol_report/en/
Sofia C, Niklas H, Valdemar G, Jaakko K. alcohol consumption and the incidence of type 2 Diabetes. Diabetes care 2003; 26(10):2785-90 DOI: https://doi.org/10.2337/diacare.26.10.2785
Kao LHW, Puddy IB, Boland LL, Watson RL, Brancati FL: Alcohol consumption and the risk of type 2 diabetes mellitus. Am J Epidemiol 2001;154:748–757. DOI: https://doi.org/10.1093/aje/154.8.748
Carlsson S, Hammar N, Persson P-G, Efendic S, Östenson C-G, Grill V: Alcohol consumption, type 2 diabetes and impaired glucose tolerance in middle-aged Swedish men. Diabet Med 2000; 17:776–781. DOI: https://doi.org/10.1046/j.1464-5491.2000.00387.x
Wei M, Gibbons LW, Mitchell TL, Kampert JB, Blair SN: Alcohol intake and incidence of type 2 diabetes in men. Diabetes Care 2000; 1:18–22. DOI: https://doi.org/10.2337/diacare.23.1.18
Shah J. Alcohol decreases insulin sensitivity in healthy subjects. Alcohol and Alcoholism. 1987 (23); 2:103-109
NHS UK. NHS Choices website. Type 2 diabetes reducing your risk. Accessed July 2016 Available from: http://www.nhs.uk/Livewell/Diabetes/Pages/Avoiddiabetes.aspx
Toshimi S, Hiroyasu I, Akio N, Takako H, et al. Cigarette Smoking and Risk of Type Diabetes Mellitus among Middle-aged and Elderly Japanese Men and Women. American J Epidemiology 2004;160 (2): 158-62. DOI: https://doi.org/10.1093/aje/kwh183
Rimm EB, Chan J, Stampfer MJ, et al. Prospective study of cigarette smoking, alcohol use and the risk of diabetes in men. BMJ 1995; 310:555–9. DOI: https://doi.org/10.1136/bmj.310.6979.555
Will JC, Galuska DA, Forda ES, Mokdada A, Calle EE. Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study. Int J Epidemiol 2001;30:540–6. DOI: https://doi.org/10.1093/ije/30.3.540
A primer on Tobacco consumption and regulation in Nigeria. Center for Public Policy Alternatives; 22 August 2015
Levitt NS, Katzenellenbogen JM, Bradshaw D, Hoffman MN, Bonnici F. The prevalence and identification of risk factors for NIDDM in urban Africans in Cape Town, South Africa. Diabetes Care, 1993; 16(4):601-7. DOI: https://doi.org/10.2337/diacare.16.4.601
King H, Rewers M. On behalf of WHO Ad Hoc Diabetes reporting group. Diabetes in adults is a third world problem. WHO 1991; 69:643-648.
Olatunbosun S T, Ojo P O, Fineberge N S, Bella A F. Prevalence of diabetes mellitus and impaired glucose intolerance in a group of urban adults in Nigeria. J Natl. Med. Assoc. 1988; 90(5): 293-301.
Nagarjan C. In northern Nigeria the street are open not just for women 2nd June 2015??
Grucza RA, Bierut LJ. Cigarrete smoking and the risk for alcohol use disorders among adolescent drinkers. Alcohol Clin Exp Res. 2006 ;30(12): 2046–2054. DOI: https://doi.org/10.1111/j.1530-0277.2006.00255.x
Shaten J, Smith G D, Kuller L H, Neaton J D. Risk factors for the development of type 2 diabetes among men enrolled in the usual care group of the multiple risk factor intervention trial. Diabetes care. 1993; 16: 1331-39-31 DOI: https://doi.org/10.2337/diacare.16.10.1331
Wicks ACB, Lowe RF, Jones JJ. Alcohol, a cause of diabetes in Rhodesia, South Afri. Med. J. 1974; 48: 1115-7.
Rimm E, Manson J, Stampfer M. Cigarette smoking and the risk of diabetes in women. Am J Public Health 1993; 83: 211 – 14. DOI: https://doi.org/10.2105/AJPH.83.2.211
The expert committee on the Diagnosis and classification of diabetes mellitus. Diabetes care 2003; 26: 3160-67 DOI: https://doi.org/10.2337/diacare.26.11.3160
US Deppartment of Health and Human Services. The Health consequences of smoking 50 yrs of progress a report of the Surgeon General Smoking and health march 2018
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.