Empowering patients living with diabetes mellitus to cease smoking will improve lower limb perfusion.
Terence CamilleriLiberato CamilleriYvonne MidoloNikolaos PapanasAlfred GattCynthia FormosaPublished in: Journal of addictive diseases (2020)
Background: To evaluate the effect of smoking on arterial perfusion and to determine whether smoking cessation would result in a significant improvement on the circulation of persons living with type 2 diabetes mellitus (T2DM).Methods: A nonexperimental comparative quantitative research was conducted amongst 32 participants with type 2 diabetes mellitus (T2DM) and controlled hyperlipidemia [smokers (n = 11), past smokers (n = 11), and nonsmokers (n = 10); aged ≥ 40 & ≤ 85 years]. Participants were matched for age, body mass index, estimated glomerular filtration rate, packet years, duration of diabetes mellitus, and glycated hemoglobin levels (HbA1c, %) utilizing frequency distribution matching. Peripheral arterial disease (PAD) was assessed utilizing the toe brachial pressure index (TBPI). TBPI value of ≤0.7 was suggestive of PAD while >0.7 was considered normal.Results: Sixty-four limbs were included for analyses. One-way ANOVA showed significant difference in the TBPI scores between the three categories (p < 0.05), with the current smokers demonstrating the lowest TBPI means (0.544), followed by past smokers (0.649) and nonsmokers having the highest TBPI (0.781). Tukey's post-hoc analysis confirmed significant difference in TBPI between current and nonsmokers (p = 0.024). Linear regression of risk predictors identified packet years as the best predictor (p = 0.004), followed by HbA1c (0.019).Conclusions: Results suggest that smoking has a significant effect on PAD in T2DM and that improved perfusion is found in past smokers. Empowering patients to cease smoking will result in better limb perfusion.
Keyphrases
- smoking cessation
- replacement therapy
- end stage renal disease
- body mass index
- ejection fraction
- newly diagnosed
- chronic kidney disease
- lower limb
- peritoneal dialysis
- contrast enhanced
- glycemic control
- type diabetes
- adipose tissue
- magnetic resonance
- patient reported outcomes
- computed tomography
- weight gain
- metabolic syndrome
- high fat diet