The current study shows a clear dose-response effect of cigarette smoking on development of proteinuria in male Type 2 diabetic patients. These findings reinforce the urgent need to encourage diabetic patients to stop smoking regardless of age, duration of diabetes mellitus or status of blood pressure control.

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We evaluated the effectiveness of diabetes education in type 2 diabetes n glycemic and diet control in primary care setting in Taiwan. We randomly assigned 157 adult patients with type 2 diabetes to intervention group receiving intensive nutrition education based on guidelines of ADA (n=74) or control group (n=73). After 12 months follow up, only patients with baseline HbA1c greater or equal to 7%, changes of HbA1c (%) (‐0.6 vs 0.0) were significantly different between two groups. After adjusting for confounders, increasing every 15 grams in carbohydrate intake was related to changes of HbA1c at increments of 0.14% (SE=0.04, p=0.001) and receiving intervention (vs control) was marginally associate with changes of HbA1c at increments of ‐0.52% (SE=0.30, p=0.092). Glycemic and dietary improvements can be achieved through diabetes education addressing nutrition aspects in primary care setting in Taiwan. The improvements of glycemic status may be related to changes in diet such as amount of carbohydrate intake.