| アブストラクト | BACKGROUND: 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. METHODS: 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. FINDINGS: 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. INTERPRETATION: 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. FUNDING: National Institute for Health Research School for Primary Care Research. |
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| ジャーナル名 | The lancet. Diabetes & endocrinology |
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| 投稿日 | 2015/5/4 |
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| 投稿者 | Lycett, Deborah; Nichols, Linda; Ryan, Ronan; Farley, Amanda; Roalfe, Andrea; Mohammed, Mohammed A; Szatkowski, Lisa; Coleman, Tim; Morris, Richard; Farmer, Andrew; Aveyard, Paul |
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| 組織名 | Coventry University, Faculty of Health and Life Sciences, Coventry, UK.;Electronic address: deborah.lycett@coventry.ac.uk.;School of Health and Population Sciences, University of Birmingham, Birmingham,;UK.;University of Bradford, Bradford, UK.;School of Medicine, University of Nottingham, Division of Epidemiology and Public;Health, Clinical Sciences Building, Nottingham City Hospital, Nottingham, UK.;School of Medicine, University of Nottingham, Division of Primary Care, Medical;School, Queen's Medical Centre, Nottingham, UK.;School of Social and Community Medicine, University of Bristol, Canynge Hall,;Bristol, UK.;University of Oxford, Nuffield Department of Primary Care Health Sciences, New;Radcliffe House Radcliffe Observatory Quarter, Oxford, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25935880/ |
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