Highlights
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Substance use disorder patterns were identified in patients with type 2 diabetes and hypertension.
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Tobacco use disorder (TUD) was associated with adverse diabetes outcomes and death.
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Alcohol use disorder with TUD vs. TUD was associated with a higher risk of death.
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Polysubstance use disorder vs. TUD associated with CVA, diabetic neuropathy, MI, and death.
Abstract
Aims
To identify substance use disorder (SUD) patterns and their association with T2DM
health outcomes among patients with type 2 diabetes and hypertension.
Methods
We used latent class analysis on electronic health records from the MetroHealth System
(Cleveland, Ohio) to obtain the target SUD groups: i) only tobacco (TUD), ii) tobacco
and alcohol (TAUD), and iii) tobacco, alcohol, and at least one more substance (PSUD).
A matching program with Mahalanobis distance within propensity score calipers created
the matched control groups: no SUD (NSUD) for TUD and TUD for the other two SUD groups.
The numbers of participants for the target-control groups were 8009 (TUD), 1672 (TAUD),
and 642 (PSUD).
Results
TUD was significantly associated with T2DM complications. Compared to TUD, the TAUD
group showed a significantly higher likelihood for all-cause mortality (adjusted odds
ratio (aOR) = 1.46) but not for any of the T2DM complications. Compared to TUD, the
PSUD group experienced a significantly higher risk for cerebrovascular accident (CVA)
(aOR = 2.19), diabetic neuropathy (aOR = 1.76), myocardial infarction (MI) (aOR =
1.76), and all-cause mortality (aOR = 1.66).
Conclusions
The findings of increased risk associated with PSUDs may provide insights for better
management of patients with T2DM and hypertension co-occurrence.
Keywords
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Article info
Publication history
Published online: November 25, 2022
Accepted:
November 21,
2022
Received in revised form:
November 17,
2022
Received:
August 4,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
