Smokeless Tobacco Use and Its Association with Type 2 Diabetes: A Case Control Study.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder characterized by hyperglycemia and insulin resistance. Its incidence is increasing globally, with a significant impact on public health. Smokeless tobacco (SLT) is a form of tobacco consumption that has been associated with various health risks, including potential effects on glucose homeostasis. This case-control study aimed to investigate the association between SLT use and T2DM. Additionally, the study aimed to assess the relationship of age, gender, socioeconomic status (SES), body mass index (BMI), family history of diabetes, physical activity, and periodontal status with T2DM participants. METHODS: The study was conducted over 24 months and included 82 T2DM cases and 164 non-diabetic controls. Demographic data, tobacco use, medical history, oral hygiene habits, BMI, and periodontal status were collected through a self-administered questionnaire and interviews. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) for Windows 26.0 (SPSS, Inc. Chicago, Illinois). RESULTS: The majority of T2DM cases were in the age group of 31-50 years, and there was a significant association between gender and T2DM, with more males being diabetic. There was no significant association between SES and diabetes. Obesity was found to be a significant risk factor for T2DM. Among SLT users, gutkha was the most commonly used product. SLT use was significantly associated with T2DM. Family history of diabetes and physical inactivity were also significantly associated with diabetes. CONCLUSION: The study suggests that SLT use is a risk factor for T2DM and may be associated with increased diabetes risk. Further research is warranted to understand the underlying mechanisms and potential interventions to reduce the impact of SLT on diabetes risk.

Smokeless Tobacco as a Risk Factor for Type 2 Diabetes Mellitus in South East Asia Region: Systematic Review and Meta-Analysis.

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder of which prevalence has been increasing steadily all over the world. There is a need of understanding the role of tobacco products in diabetes mellitus, especially smokeless tobacco (ST) products. Objective: To analyze if ST is a determinant for T2DM among patients in South East Asia Region (SEAR) and secondly to obtain the pooled prevalence of use of ST in T2DM patients/participants from these studies. Materials and Methods: PubMed, Google Scholar, EBSCO, and Scopus are the databases that were searched to find desired manuscripts, which fulfilled the inclusion criteria to undertake this systematic review and meta-analysis (SRMA). Meta-analysis was carried out to determine the pooled effect size for the odds ratio of ST use in T2DM with 95% CI. MedCalc statistical software was used followed by the DerSimonian and Laird method under the random effect model. Results: A total of 8 manuscripts were involved in the systematic review and 7 in the meta-analysis. Odds of 1.39 indicating increased frequency of using ST among T2DM patients or survey participants was observed, which was not significant with C.I. 95% (0.843-2.288) and P < 0.001 with high heterogeneity. The pooled prevalence of use of ST in T2DM is 24.08% (CI 15.67 to 33.64) under random effect model with I2 inconsistency of 97.16% in 8 studies from India and Bangladesh. Conclusion: This pooled analysis shows that ST use is not a risk factor for T2DM. The number of studies included in the SRMA from SEAR is limited having no representation from Myanmar, Bhutan, Timor Leste, and Sri Lanka.