title: Alcohol and cigarette use among adolescents with type 1 diabetes.
abstract: In this study, we compare the prevalence of alcohol and cigarette use among Polish adolescents with type 1 diabetes mellitus (T1DM) (n = 209), aged 15-18 years, with that of a large cohort of their healthy peers, using standardized questionnaire used in the European School Survey Project on Alcohol and Drugs (ESPAD). The lifetime, previous year, and past 30-day prevalence of alcohol consumption was high among adolescents with T1DM but lower than in the controls (82.8 vs 92.0%, 71.7 vs 85.6%, and 47.5 vs 69.7%, respectively, p < 10-5). The lifetime and 30-day prevalence of cigarette use was also lower among patients than the controls (54.6 vs 65.5%, p = 0.001 and 27.3 vs 35.9%, p = 0.012, respectively). Patients who admitted smoking exhibited worse metabolic control than non-smokers (p < 0.0001) and had a higher chance of developing diabetic ketoacidosis. The incidence of severe hypoglycemia was higher among those who reported getting drunk in the previous 30 days (p = 0.04) and lifetime smoking (p = 0.01).
  
  
  CONCLUSIONS
  Although alcohol and cigarette consumption is lower than in controls, it is common among teenagers with type 1 diabetes, effecting metabolic control and causing the risk of acute diabetes complications. Better prevention strategies should be implemented in this group of patients in their early teen years. What is Known: • Substance use remains a significant cause of morbidity and mortality among teenagers with type 1 diabetes. • Current medical literature contains inconsistent data on the prevalence of alcohol and cigarette use among adolescents with type 1 diabetes, mostly due to methodological problems with conducting such surveys. What is New: • Methodological approach: we used a validated questionnaire from the European School Survey Project on Alcohol and Other Drugs (ESPAD) and compared the results to a large national control group of 12,114 healthy students who took part in ESPAD in 2011.
authors.affiliation: Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, ul. Sporna 36/50, 91-738, Lodz, Poland. anna.hogendorf@gmail.com.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Hogendorf
authors.affiliation: Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, ul. Sporna 36/50, 91-738, Lodz, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Fendler
authors.affiliation: Department of Studies on Alcoholism and Other Dependencies, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957, Warsaw, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Sierosławski
authors.affiliation: Students' Scientific Circle at the Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Sporna 36/50, 91-738, Lodz, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Bobeff
authors.affiliation: Students' Scientific Circle at the Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Sporna 36/50, 91-738, Lodz, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Węgrewicz
authors.affiliation: Students' Scientific Circle at the Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Sporna 36/50, 91-738, Lodz, Poland.
authors.forename: Kamila I
authors.initials: KI
authors.lastname: Malewska
authors.affiliation: Students' Scientific Circle at the Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Sporna 36/50, 91-738, Lodz, Poland.
authors.forename: Maciej W
authors.initials: MW
authors.lastname: Przudzik
authors.affiliation: Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Debinki 7, 80-952, Gdansk, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Szmigiero-Kawko
authors.affiliation: Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Debinki 7, 80-952, Gdansk, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Sztangierska
authors.affiliation: Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Debinki 7, 80-952, Gdansk, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Myśliwiec
authors.affiliation: Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, ul. Sporna 36/50, 91-738, Lodz, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szadkowska
authors.affiliation: Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, ul. Sporna 36/50, 91-738, Lodz, Poland.
authors.forename: Wojciech M
authors.initials: WM
authors.lastname: Młynarski
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*
keywords: Adolescents; Alcohol; Cigarettes; Metabolic control; Type 1 diabetes