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Integrating substance abuse care with community diabetes care: implications for research and clinical practice

机译：将药物滥用护理与社区糖尿病护理相结合：对研究和临床实践的启示

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Cigarette smoking and alcohol use are prevalent among individuals with diabetes in the US, but little is known about screening and treatment for substance use disorders in the diabetic population. This commentary discusses the scope and clinical implications of the public health problem of coexisting substance use and diabetes, including suggestions for future research. Diabetes is the seventh leading cause of death in the US, and is associated with many severe health complications like cardiovascular disease, stroke, kidney damage, and limb amputations. There are an estimated 24 million adults in the US with type 2 diabetes. Approximately 20% of adults aged 18 years or older with diabetes report current cigarette smoking. The prevalence of current alcohol use in the diabetic population is estimated to be around 50%–60% in epidemiological surveys and treatment-seeking populations. Cigarette smoking is associated with an increased risk of type 2 diabetes in a dose-dependent manner and is an independent modifiable risk factor for development of type 2 diabetes. Diabetic patients with an alcohol or other drug use disorder show a higher rate of adverse health outcomes. For example, these patients experience more frequent and severe health complications as well as an increased risk of hospitalization, and require longer hospital stays. They are also less likely to seek routine care for diabetes or adhere to diabetes treatment than those without an alcohol or other drug use disorder. The Affordable Care Act of 2010 and the Mental Health Parity Act and Addiction Equity Act of 2008 provide opportunities for facilitating integration of preventive services and evidence-based treatments for substance use disorders with diabetes care in community-based medical settings. These laws also offer emerging areas for research.
机译：在美国，吸烟和饮酒在糖尿病患者中很普遍，但对于糖尿病人群中药物滥用疾病的筛查和治疗知之甚少。这篇评论讨论了物质使用和糖尿病并存的公共卫生问题的范围和临床意义，包括对未来研究的建议。糖尿病是美国第七大死亡原因，并与许多严重的健康并发症如心血管疾病，中风，肾脏损害和截肢有关。在美国，估计有2400万成年人患有2型糖尿病。年龄在18岁以上的糖尿病患者中，大约20％的人报告当前吸烟。在流行病学调查和寻求治疗的人群中，糖尿病人群中目前饮酒的患病率估计约为50％至60％。吸烟以剂量依赖的方式与2型糖尿病的风险增加相关，并且是2型糖尿病发展的独立可改变的危险因素。患有酒精或其他药物使用障碍的糖尿病患者显示出更高的不良健康结果发生率。例如，这些患者经历更频繁和严重的健康并发症以及住院风险增加，并且需要更长的住院时间。与没有酒精或其他药物使用障碍的人相比，他们也不太可能寻求糖尿病的常规护理或坚持接受糖尿病治疗。 2010年的《平价医疗法案》以及2008年的《精神健康平等法和成瘾平等法》为在社区医疗机构中为糖尿病患者提供预防性服务和循证治疗药物滥用的机会。这些法律也为研究提供了新兴领域。

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