Cigarette Smoking and Diabetes: An Update

Mühlhauser, Ingrid

doi:10.1111/j.1464-5491.1994.tb00283.x

Cited by 67 publications

(38 citation statements)

References 98 publications

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“…Few studies have evaluated the effectiveness of interventions with diabetic smokers using a randomized design, and those studies did not have very optimistic results (2,4,5). Moreover, the limited number of studies on smoking cessation in diabetes, which generally have not used a randomized design and are based on small sample sizes, supports the proposal that more research on intervention programs tailored to diabetic smokers is needed (2).…”

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confidence: 99%

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Intervention study for smoking cessation in diabetic patients: a randomized controlled trial in both clinical and primary care settings.

et al. 2000

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Abbreviations: CHD, coronary heart disease; FTND, Fagerström Test for Nicotine Dependence; NRT, nicotine replacement therapy.A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Intervention Study for Smoking Cessation in Diabetic PatientsA randomized controlled trial in both clinical and primary care settingsOBJECTIVE -To evaluate the effectiveness of a nurse-managed smoking cessation intervention in diabetic patients. RESEARCH DESIGN AND METHODS -This randomized controlled clinical trialinvolved 280 diabetic smokers (age range 17-84 years) who were randomized either into control (n = 133) or intervention (n = 147) groups at 12 primary care centers and 2 hospitals located in Navarre, Spain. The intervention consisted of a 40-min nurse visit that included counseling, education, and contracting information (a negotiated cessation date). The followup consisted of telephone calls, letters, and visits. The control group received the usual care for diabetic smokers. Baseline and 6-month follow-up measurements included smoking status (self-reported cessation was verified by urine cotinine concentrations), mean number of cigarettes smoked per day, and stage of change.RESULTS -At the 6-month follow-up, the smoking cessation incidence was 17.0% in the intervention group compared with 2.3% in the usual care group, which was a 14.7% difference (95% CI 8.2-21.3%). Among participants who continued smoking, a significant reduction was evident in the average cigarette consumption at the 6-month follow-up. The mean number of cigarettes per day decreased from 20.0 at baseline to 15.5 at 6 months for the experimental group versus from 19.7 to 18.1 for the control group (P Ͻ 0.01).CONCLUSIONS -A structured intervention managed by a single nurse was shown to be effective in changing the smoking behavior of diabetic patients.

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“…Evidence that cigarette consumption has a synergic effect with diabetes and increases the morbidity and mortality of type 1 and 2 diabetic patients is accumulating (2-6). However, smoking prevalence among diabetic patients has been estimated to be almost the same as in the general population (4,7).…”

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Intervention study for smoking cessation in diabetic patients: a randomized controlled trial in both clinical and primary care settings.

et al. 2000

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“…Subsequent systematic reviews have strengthened these conclusions while adding evidence that smoking increases insulin resistance, worsens diabetes control, and may even induce the disease. 2,3 Many cross-sectional and prospective studies of patients who have diabetes also show that cardiovascular and all-cause mortality is higher in those who smoke than in those who do not smoke. [4][5][6][7] Thus, the 1 in 5 persons with diabetes who also smoke represent a particularly important target for intervention, both by clinicians and by policy makers in health plans and public health.…”

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Diabetic Patients Who Smoke: Are They Different?

Solberg

Desai²,

O’Connor³

et al. 2004

The Annals of Family Medicine

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BACKGROUND We wanted to identify differences between diabetic patients who smoke and those who do not smoke to design more effective strategies to improve their diabetes care and encourage smoking cessation.METHODS A random sample of adult health plan members with diabetes were mailed a survey questionnaire, with telephone follow-up, asking about their attitudes and behaviors regarding diabetes care and smoking. Among the 1,352 respondents (response rate 82.4%), we found 188 current smokers whose answers we compared with those of 1,264 nonsmokers, with statistical adjustment for demographic characteristics and duration of diabetes. RESULTSSmokers with diabetes were more likely to report fair or poor health (odds ratio [OR] = 1.5, P = .03) and often feeling depressed (OR = 1.7, P = .004). Relative to nonsmokers, smokers had lower rates of checking blood glucose levels, were less physically active, and had fewer diabetes care visits, glycated hemoglobin (A 1c ) tests, foot examinations, eye examinations, and dental checkups (P ≤.01). Smokers also reported receiving and desiring less support from family and friends for specifi c diabetic self-management activities and had lower readiness to quit smoking than has been observed in other population groups.CONCLUSIONS Clinicians should be aware that diabetic patients who smoke are more likely to report often feeling depressed and, even after adjusting for depression, are less likely to be active in self-care or to comply with diabetes care recommendations. Diabetic patients who smoke are special clinical challenges and are likely to require more creative and consistent clinical interventions and support. INTRODUCTIONS moking has long been known to worsen the prognosis of patients with diabetes. Mulhauser' s literature review in 1990 1 concluded that the frequency of smoking in adults with diabetes was comparable to that in the general population and that smoking is a major risk factor for both macrovascular and microvascular complications. Subsequent systematic reviews have strengthened these conclusions while adding evidence that smoking increases insulin resistance, worsens diabetes control, and may even induce the disease.2,3 Many cross-sectional and prospective studies of patients who have diabetes also show that cardiovascular and all-cause mortality is higher in those who smoke than in those who do not smoke. [4][5][6][7] Thus, the 1 in 5 persons with diabetes who also smoke represent a particularly important target for intervention, both by clinicians and by policy makers in health plans and public health.Despite this information, and despite strong evidence that clinician support of smoking cessation is effective for smokers among the general population and those with diabetes, [8][9][10] only 58% of patients with diabetes who smoke reported that a physician had ever advised them to stop or cut down on their smoking. In the past, many diabetes care specialists and some professional organizations have concentrated largely on glucose-oriented diabetes ca...

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“…The reasons for this excess mortality are not fully understood, but patients with renal dysfunction tend to have a clustering of cardiovascular risk factors including hypertension, smoking, hyperlipidaemia, endothelial dysfunction and increased fibrinogen/platelets aggregability [22][23][24] ( Figure 1). In those with microalbuminuria there is also a higher prevalence of insulin resistance, poor glycaemic control, left ventricular hypertrophy, proliferative retinopathy, neuropathy, peripheral vascular disease and foot ulcers.…”

Section: Morbidity and Mortality Associated With Diabetic Renal Dysfumentioning

confidence: 99%

Responding to the challenge of diabetic nephropathy: the historic evolution of detection, prevention and management

2000

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Diabetic nephropathy remains a leading cause of endstage renal disease (ESRD) in western societies, accounting for about 40% of all patients beginning renal replacement therapy. Patients with type 2 diabetes comprise the largest and fastest growing single disease group requiring renal replacement therapy. In addition to the high risk of progression to ESRD, diabetic nephropathy is associated with a very high risk of cardiovascular (CV) morbidity and mortality, which is not abolished by dialysis or renal transplantation. Over the past two decades there have been major advances in our attempts to understand the risk factors for development and progression of diabetic renal dysfunction, that have resulted in better characterisation of the natural history of this serious complication. Effective antihypertensive treatment and aggressive management of CV risk factors have helped improve the prognosis of patients with overt diabetic nephropathy, particularly those with type 1 diabetes. However, for the larger proportion of patients with type 2 diabetes, the renal and CV prognoses are still poor. Recently, more focus has been placed on treating diabetic patients early in order to prevent future organ damage. Microalbuminuria is an

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Cigarette Smoking and Diabetes: An Update

Cited by 67 publications

References 98 publications

Intervention study for smoking cessation in diabetic patients: a randomized controlled trial in both clinical and primary care settings.

Intervention study for smoking cessation in diabetic patients: a randomized controlled trial in both clinical and primary care settings.

Diabetic Patients Who Smoke: Are They Different?

Responding to the challenge of diabetic nephropathy: the historic evolution of detection, prevention and management

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