Key result
Smoking in patients with diabetes was associated with a significant difference in HBA1C compared to non-smokers (mean difference 0.61%; 95% CI -0.88 to -0.33; P<0.001).
Why the study?
Smoking is linked to vascular complications in diabetes and may affect cardio-metabolic parameters, but the relationship between smoking, smoking cessation, and these parameters required investigation.
Does smoking and its cessation affect cardio-metabolic parameters in patients with type 1 or type 2 diabetes?
Meta-Analysis (n=98,978)
Does smoking and its cessation affect cardio-metabolic parameters in patients with type 1 or type 2 diabetes?
Smoking is associated with worse glycemic and lipid profiles in patients with diabetes, and smoking cessation does not worsen long-term HbA1c while potentially improving lipid profiles.
Background: Smoking is associated with an increase in macrovascular and microvascular complications in people with diabetes. In addition to other concomitant vascular disturbances, it also appears to affect cardio-metric parameters. This may partly explain the acceleration of vascular complications in people with diabetes. This study aimed to investigate the relationship between smoking and its cessation in cardio-metric parameters in diabetes. Materials and Methods: Searches were conducted in Medline, Embase, and CINAHL. After screening 6866 studies, 14 observational studies with a total of 98978 participants with type 1 or type 2 diabetes were selected for the investigation. Results: Meta-analysis demonstrated that the mean difference of hemoglobin A1c (HBA1C) between non-smokers and smokers was 0.61% (95% confidence interval [CI] -0.88 to -0.33, P<0.001). The difference in low-density lipoprotein cholesterol between non-smokers and smokers was 0.11 mmol/L (95% CI -20.21 to 0.01, P=0.04). The difference in high-density lipoprotein cholesterol between non-smokers and smokers was 0.12 mmol/L (95% CI 0.08-0.15, P<0.001). However, there was no statistically significant difference in blood pressure (BP) between the two groups. The difference in HBA1C between quitters and continuing smokers was not statistically significant at 10.0.10% (95 CI -0.42 to 0.21, P=0.53). Conversely, the results revealed that over 10 years, HBA1C was comparable between non-smokers and quitters. Conclusion: Smoking in patients with diabetes was widespread and should be the target of smoking cessation campaigns. Smoking cessation does not lead to an increase in HBA1C in the long term and may reduce vascular complications in diabetes by its desirable effect on the lipid profile.
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Ghabimi et al. (2023) conducted a meta-analysis in Type 1 or type 2 diabetes (n=98,978). Smoking vs. Non-smokers was evaluated on Hemoglobin A1c (HBA1C) (MD 0.61, 95% CI -0.88 to -0.33, p=<0.001). Smoking in patients with diabetes was associated with a significant difference in HBA1C compared to non-smokers (mean difference 0.61%; 95% CI -0.88 to -0.33; P<0.001).
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