Among people with type 1 diabetes, currently smoking tobacco is linked to worse blood glucose control than being a former smoker, according to a new study published in the Journal of Diabetes and its Complications — indicating that quitting smoking may help improve blood glucose control.
While there are mounds of evidence that smoking is bad for health in general — including cardiovascular health, which is a major concern for people with diabetes — there are only limited studies on the impact of smoking on blood glucose control in people with diabetes. When it comes to cardiovascular health, though, there is consensus that quitting smoking is beneficial even if it leads to weight gain — a common side effect of stopping tobacco use in many people. At the same time, there is evidence — some of it not necessarily up to date — that tobacco use remains common in many people with diabetes, especially younger people. This means that the impact of smoking on blood glucose control — as well as the impact of quitting — remains a relevant issue in the diabetes community.
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For the latest study, researchers looked at responses to a questionnaire from 933 adults with type 1 diabetes, who had an average age of 38. The questionnaire covered topics including serious high and low blood glucose episodes, diabetes self-care in general, diabetes-related distress, and blood glucose self-monitoring. They also got certain information from these participants’ medical records, including their A1C levels (a measure of long-term glucose control), any diagnosis related to kidney disease or peripheral neuropathy (nerve damage in the limbs), and body-mass index (BMI, a measure of body weight that takes height into account). Then they compared participants’ self-reported smoking status — as a former smoker, current smoker, or never-smoker, as well as how often people smoked — with all of these diabetes-related health outcomes.
Quitting smoking linked to a variety of diabetes-related benefits
The majority of participants, 55%, had never used tobacco regularly. Another 27% were former smokers, and 18% were current smokers. Among current smokers, 31% reported using tobacco daily. The researchers found that after controlling for a number of differences between the tobacco groups — such as age, race or ethnicity, insurance status, and whether they used an insulin pump or continuous glucose monitoring (CGM) system — smoking status was linked to several different health outcomes, including A1C, BMI, diabetes self-care habits, diabetes-related distress, and the frequency of blood glucose self-monitoring. For most of these outcomes, current smokers had worse outcomes than never-smokers, and former smokers tended to have outcomes similar to those of never-smokers — suggesting that quitting smoking could offer substantial diabetes-related health benefits, as noted in a Healio article on the study.
The researchers concluded that these results “point to potential diabetes-specific motivators that could inform tobacco cessation interventions.” In other words, doctors could discuss the potential for improvements in blood glucose control and other diabetes-related measures in people with diabetes who currently smoke, if they were to quit — rather than just discussing the long-term risks linked to smoking. “Tailored messaging and targeted prevention and intervention efforts are needed to further decrease tobacco use in this high-risk population,” the researchers noted.
Want tips on how to kick the habit? Read “Quitting Smoking With Diabetes.”