The association between smoking cessation and glycaemic control in patients with type 2 diabetes: a THIN database cohort study
<p><strong>Background</strong> Smoking increases the risk of developing type 2 diabetes. However, several population studies also show a higher risk in people 3–5 years after smoking cessation than in continuing smokers. After 10–12 years the risk equates to that of never-smokers....
| Main Authors: | , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2015
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| _version_ | 1797106032944611328 |
|---|---|
| author | Lycett, D Nichols, L Ryan, R Farley, A Roalfe, A Mohammed, M Szatkowski, L Coleman, T Morris, R Farmer, A Aveyard, P |
| author_facet | Lycett, D Nichols, L Ryan, R Farley, A Roalfe, A Mohammed, M Szatkowski, L Coleman, T Morris, R Farmer, A Aveyard, P |
| author_sort | Lycett, D |
| collection | OXFORD |
| description | <p><strong>Background</strong>
Smoking increases the risk of developing type 2 diabetes. However, several population studies also show a higher risk in people 3–5 years after smoking cessation than in continuing smokers. After 10–12 years the risk equates to that of never-smokers. Small cohort studies suggest diabetes control deteriorates temporarily during the first year after quitting. We examined whether or not quitting smoking was associated with altered diabetes control in a population study, for how long this association persisted, and whether or not this association was mediated by weight change.</p>
<p><strong>Methods</strong>
We did a retrospective cohort study (Jan 1, 2005, to Dec 31, 2010) of adult smokers with type 2 diabetes using The Health Improvement Network (THIN), a large UK primary care database. We developed adjusted multilevel regression models to investigate the association between a quit event, smoking abstinence duration, change in HbA1c, and the mediating effect of weight change.</p>
<p><strong>Findings</strong>
10 692 adult smokers with type 2 diabetes were included. 3131 (29%) quit smoking and remained abstinent for at least 1 year. After adjustment for potential confounders, HbA1c increased by 0·21% (95% CI 0·17–0·25; p<0·001; [2·34 mmol/mol (95% CI 1·91–2·77)]) within the first year after quitting. HbA1c decreased as abstinence continued and became comparable to that of continual smokers after 3 years. This increase in HbA1c was not mediated by weight change.</p>
<p><strong>Interpretation</strong>
In type 2 diabetes, smoking cessation is associated with deterioration in glycaemic control that lasts for 3 years and is unrelated to weight gain. At a population level, this temporary rise could increase microvascular complications.</p> |
| first_indexed | 2024-03-07T06:55:55Z |
| format | Journal article |
| id | oxford-uuid:fe231515-caf8-4079-9be5-6a8156595371 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:55:55Z |
| publishDate | 2015 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:fe231515-caf8-4079-9be5-6a81565953712022-03-27T13:34:04ZThe association between smoking cessation and glycaemic control in patients with type 2 diabetes: a THIN database cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fe231515-caf8-4079-9be5-6a8156595371EnglishSymplectic Elements at OxfordElsevier2015Lycett, DNichols, LRyan, RFarley, ARoalfe, AMohammed, MSzatkowski, LColeman, TMorris, RFarmer, AAveyard, P<p><strong>Background</strong> Smoking increases the risk of developing type 2 diabetes. However, several population studies also show a higher risk in people 3–5 years after smoking cessation than in continuing smokers. After 10–12 years the risk equates to that of never-smokers. Small cohort studies suggest diabetes control deteriorates temporarily during the first year after quitting. We examined whether or not quitting smoking was associated with altered diabetes control in a population study, for how long this association persisted, and whether or not this association was mediated by weight change.</p> <p><strong>Methods</strong> We did a retrospective cohort study (Jan 1, 2005, to Dec 31, 2010) of adult smokers with type 2 diabetes using The Health Improvement Network (THIN), a large UK primary care database. We developed adjusted multilevel regression models to investigate the association between a quit event, smoking abstinence duration, change in HbA1c, and the mediating effect of weight change.</p> <p><strong>Findings</strong> 10 692 adult smokers with type 2 diabetes were included. 3131 (29%) quit smoking and remained abstinent for at least 1 year. After adjustment for potential confounders, HbA1c increased by 0·21% (95% CI 0·17–0·25; p<0·001; [2·34 mmol/mol (95% CI 1·91–2·77)]) within the first year after quitting. HbA1c decreased as abstinence continued and became comparable to that of continual smokers after 3 years. This increase in HbA1c was not mediated by weight change.</p> <p><strong>Interpretation</strong> In type 2 diabetes, smoking cessation is associated with deterioration in glycaemic control that lasts for 3 years and is unrelated to weight gain. At a population level, this temporary rise could increase microvascular complications.</p> |
| spellingShingle | Lycett, D Nichols, L Ryan, R Farley, A Roalfe, A Mohammed, M Szatkowski, L Coleman, T Morris, R Farmer, A Aveyard, P The association between smoking cessation and glycaemic control in patients with type 2 diabetes: a THIN database cohort study |
| title | The association between smoking cessation and glycaemic control in patients with type 2 diabetes: a THIN database cohort study |
| title_full | The association between smoking cessation and glycaemic control in patients with type 2 diabetes: a THIN database cohort study |
| title_fullStr | The association between smoking cessation and glycaemic control in patients with type 2 diabetes: a THIN database cohort study |
| title_full_unstemmed | The association between smoking cessation and glycaemic control in patients with type 2 diabetes: a THIN database cohort study |
| title_short | The association between smoking cessation and glycaemic control in patients with type 2 diabetes: a THIN database cohort study |
| title_sort | association between smoking cessation and glycaemic control in patients with type 2 diabetes a thin database cohort study |
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