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Smoking, Quitting Smoking, and the Risk for Type 2 Diabetes FREE

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The summary below is from the full report titled “Smoking, Smoking Cessation, and the Risk for Type 2 Diabetes Mellitus. A Cohort Study.” It is in the 5 January 2010 issue of Annals of Internal Medicine (volume 152, pages 10-17). The authors are H.C. Yeh, B.B. Duncan, M.I. Schmidt, N.Y. Wang, and F.L. Brancati.

Ann Intern Med. 2010;152(1):I-44. doi:10.7326/0003-4819-152-1-201001050-00002
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What is the problem and what is known about it so far?

Type 2 diabetes mellitus is a common disease that interferes with the body's ability to store energy. The pancreas makes a substance called insulin, which helps the body store energy from food. In type 2 diabetes (adult-onset diabetes), the body makes plenty of insulin but cannot use it normally. The result is high levels of blood sugar, which can eventually lead to blindness, kidney failure, nerve damage, and heart disease. Fortunately, good care with diet, exercise, and medications can prevent complications. Persons who are overweight, have a family history of diabetes, are older, or had diabetes during pregnancy are at higher risk for type 2 diabetes than persons without these risk factors. Smokers also have a higher risk for type 2 diabetes than nonsmokers, but the cause of this relationship is not well understood. It is also not known whether quitting smoking decreases a person's risk for diabetes. Quitting smoking decreases inflammation in the body, and inflammation may have something to do with the development of diabetes. However, quitting smoking sometimes causes weight gain, and weight gain could increase the risk for diabetes.

Why did the researchers do this particular study?

To see what happens to diabetes risk when smokers quit.

Who was studied?

10 892 adults aged 45 to 64 years who did not have diabetes when they entered the study in 1987 to 1989. They were participating in a large study of risk factors for heart disease.

How was the study done?

The researchers followed the patients for more than 10 years and collected information from blood tests and surveys about whether persons developed diabetes. They also collected information on smoking behaviors over the years of the study. While accounting for other diabetes risk factors, they compared the risk for diabetes among nonsmokers, smokers, and quitters.

What did the researchers find?

As expected, the researchers found that smokers had a higher risk for diabetes than never-smokers. However, among smokers who quit, the risk for diabetes was highest within 3 years of quitting and decreased to no excess risk after about 10 years. Weight gain seemed to account in part for the increased risk for diabetes in the first few years after quitting.

What were the limitations of the study?

There could be differences in characteristics of quitters and nonquitters that explain diabetes risk but the researchers could not measure in this study.

What are the implications of the study?

When smokers quit, they should get advice about how to prevent weight gain and be monitored for diabetes in the years soon after quitting. Quitting smoking provides many health and other benefits. Persons should not continue to smoke to reduce diabetes risk. The best way to reduce the risk for smoking-related diabetes is not to start smoking.





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