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Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study

Author

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  • Jin-Hyeong Kim

    (Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea)

  • Juhwan Noh

    (Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea)

  • Jae-Woo Choi

    (Busan Public Health Policy Institute, Busan 47527, Korea)

  • Eun-Cheol Park

    (Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
    Institute of Health Services Research, Yonsei University College of Medicine, Seoul 03722, Korea)

Abstract

Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios ( p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR ( p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations ( p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations ( p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.

Suggested Citation

  • Jin-Hyeong Kim & Juhwan Noh & Jae-Woo Choi & Eun-Cheol Park, 2017. "Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study," IJERPH, MDPI, vol. 14(6), pages 1-9, June.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:6:p:655-:d:101957
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    References listed on IDEAS

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    3. Sultan Ayoub Meo & Thamir Al-khlaiwi & Abdulelah Adnan Abukhalaf & Ali Abdullah Alomar & Omar Mohammed Alessa & Faris Jamal Almutairi & Majed Mohammed Alasbali, 2020. "The Nexus between Workplace Exposure for Wood, Welding, Motor Mechanic, and Oil Refinery Workers and the Prevalence of Prediabetes and Type 2 Diabetes Mellitus," IJERPH, MDPI, vol. 17(11), pages 1-10, June.
    4. Enrico Paci & Daniela Pigini & Lisa Bauleo & Carla Ancona & Francesco Forastiere & Giovanna Tranfo, 2018. "Urinary Cotinine Concentration and Self-Reported Smoking Status in 1075 Subjects Living in Central Italy," IJERPH, MDPI, vol. 15(4), pages 1-8, April.

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