Effect of cigarette smoking and of a transdermal nicotine delivery system on glucoregulation in type 2 diabetes mellitus

Epifano, L.; Vincenzo, Angelo Di; Fanelli, Carmine G.; Porcellati, Francesca; Perriello, G.; Feo, Pierpaolo De; Motolese, M; Brunetti, P; Bolli, Geremia B.

doi:10.1007/bf02333019

Cited by 46 publications

(39 citation statements)

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“…For diabetes, several human studies demonstrate nicotine exposure results in enhanced insulin resistance in type 2 diabetics but not in healthy individuals (Axelsson et al 2001; Epifano et al 1992). For example, a study from Axelsson and co-workers investigated the effects of acute intravenous nicotine infusion on insulin sensitivity in non-smoker type 2 diabetics versus healthy non-smoker controls.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of possible serious adverse health effects of nicotine replacement therapy

Fariss

2016

Arch Toxicol

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We conducted a systematic literature review to identify and critically evaluate studies of serious adverse health effects (SAHEs) in humans using nicotine replacement therapy (NRT) products. Serious adverse health effects refer to adverse events, leading to substantial disruption of the ability to conduct normal life functions. Strength of evidence evaluations and conclusions were also determined for the identified SAHEs. We evaluated 34 epidemiological studies and clinical trials, relating NRT use to cancer, reproduction/development, CVD, stroke and/or other SAHEs in patients, and four meta-analyses on effects in healthy populations. The overall evidence suffers from many limitations, the most significant being the short-term exposure (≤12 weeks) and follow-up to NRT product use in most of the studies, the common failure to account for changes in smoking behaviour following NRT use, and the sparse information on SAHEs by type of NRT product used. The only SAHE from NRT exposure we identified was an increase in respiratory congenital abnormalities reported in one study. Limited evidence indicated a lack of effect between NRT exposure and SAHEs for CVD and various reproduction/developmental endpoints. For cancer, stroke and other SAHEs, the evidence was inadequate to demonstrate any association with NRT use. Our conclusions agree with recent statements from authoritative bodies.Electronic supplementary materialThe online version of this article (doi:10.1007/s00204-016-1856-y) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

A systematic review of possible serious adverse health effects of nicotine replacement therapy

Fariss

2016

Arch Toxicol

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“…There is some evidence that cigarette smoking could acutely impair insulin action in normal subjects and T2DM patients (31, 32) and clinical studies have shown that direct negative effects of smoking on β-cells (21). Similarly, this study revealed that daily cigarette consumption was positively associated with insulin secretion and the latter was negatively related to T2DM.…”

Section: Discussionmentioning

confidence: 99%

Interaction between heavy smoking and CYP2A6 genotypes on type 2 diabetes and its possible pathways

Liu

Chen

David³

et al. 2011

European Journal of Endocrinology

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Objective To explore the interactions between smoking and CYP2A6 genotypes on type 2 diabetes (T2DM) as well as potential pathways for smoking in causing T2DM. Design Cross-sectional study. Methods A total of 1344 smokers with complete data from a community-based T2DM survey in Guangzhou and Zhuhai of China from July 2006 to June 2007 were interviewed with a structured questionnaire about socio-demographic status and daily cigarette consumption. Serum glucose, insulin, and cotinine were measured after an overnight fast. Subjects were genotyped for CYP2A6 and classified, according to genotype, into normal, intermediate, slow, or poor nicotine metabolizers based on prior knowledge of CYP2A6 allele associations with nicotine C-oxidation rate. Abdominal obesity was defined as a waist-to-hip ratio ≥0.90 for males or ≥0.85 for females. Type 2 diabetic patients (n=154) were diagnosed according to WHO 1999 criteria. Chi-square tests, multivariate logistic regression models, and a structural equation model were used in this study. Results Multivariate analysis indicated that, compared with light smoking, heavy smoking significantly increased the risk of T2DM (odds ratio (OR)=1.75, 95% CI=1.01–3.05). There were significant interactions between heavy smoking and slow CYP2A6 (OR=5.12, 95% CI=1.08–24.23) and poor CYP2A6 metabolizer genotypes (OR=8.54, 95% CI=1.28–57.02) on T2DM. Structural equation modeling indicated that CYP2A6 moderation of smoking quantity risk on T2DM was mediated by the effects on serum cotinine, abdominal obesity, insulin resistance, and insulin secretion. Conclusions Heavy smoking was significantly associated with T2DM, and this association was moderated by CYP2A6 genotype and mediated by serum cotinine, abdominal obesity, insulin resistance, and insulin secretion.

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“…This acute effect could be mediated by a stimulation of the sympathetic nervous system by nicotine, leading to enhanced catecholamine levels and insulin resistance. Indeed, long-term use of nicotine-containing chewing gum has been associated with insulin resistance (26), and some studies indicate that acute administration of nicotine induces insulin resistance (27). However, transient acute smoking does not appear to affect insulin secretion (27), and the long-term effects of tobacco use on insulin secretion remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, long-term use of nicotine-containing chewing gum has been associated with insulin resistance (26), and some studies indicate that acute administration of nicotine induces insulin resistance (27). However, transient acute smoking does not appear to affect insulin secretion (27), and the long-term effects of tobacco use on insulin secretion remain unclear. In the Stockholm Diabetes Prevention study (28), a cross-sectional study of 3,129 middle-aged Swedish men, the risk of diabetes was increased in current smokers compared with former smokers.…”

Section: Discussionmentioning

confidence: 99%

Cigarette Smoking and the Risk of Gestational and Pregestational Diabetes in Two Consecutive Pregnancies

et al. 2003

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OBJECTIVE -Cigarette smoking during pregnancy may increase the risk of gestational diabetes mellitus (GDM) or pregestational diabetes mellitus (PDM). Smoking has been associated positively with hyperinsulinemia and insulin resistance in experimental studies, although the association with diabetes remains unclear. To further explore this issue, we examined the association with smoking in the largest prospective cohort study of GDM and PDM to date. RESEARCH DESIGN AND METHODS-The study population comprised 212,190 women in the population-based Swedish Birth Registry who had their first and second deliveries between January 1987 and December 1995. Maternal characteristics were recorded in a standardized manner at the first prenatal visit, followed by a clinical examination and a standardized in-person interview to assess lifestyle habits. Women were categorized as nonsmokers, light smokers (one to nine cigarettes per day), or moderate-to-heavy smokers (at least 10 cigarettes per day).RESULTS -Women with GDM in their first pregnancy experienced an eight-to ninefold increased risk of GDM or PDM in their second pregnancy. Cigarette smoking was not associated with increased risk of these conditions. Neither women who smoked during their first and second pregnancies nor those who commenced smoking between pregnancies had a higher risk of GDM or PDM than nonsmokers.CONCLUSIONS -Our findings do not support an association between cigarette smoking and risk of GDM or PDM in young women of childbearing age. Diabetes Care 26:2994 -2998, 2003G estational diabetes mellitus (GDM) is defined as the onset or recognition of glucose intolerance during pregnancy (1). GDM has been associated with pre-eclampsia and perinatal conditions such as macrosomia, fetal hyperinsulinemia, and perinatal mortality (1,2). Women with GDM also have an increased risk of developing overt diabetes later in life (2). Thus, glucose control in pregnancy is an important way of reducing the risk of maternal and fetal complications.Cigarette smoking has been associated positively with HbA 1c levels, which reflect long-term glucose levels in some (3-5) but not all (6,7) studies to date. Cigarette smoking also has been associated positively with hyperinsulinemia and insulin resistance in some (but not all) studies (8), including those that have compared the glucose response of smokers and nonsmokers in glucose tolerance tests. Nevertheless, the association between smoking and GDM itself remains unclear (8). The Nurses' Health Study (9), which is the only cohort study that has examined this association previously, found a statistically significant 40% increased risk of GDM among 1,433 current smokers compared with 10,288 never smokers. Supporting these findings, recent cross-sectional data among pregnant women in Scandinavia suggest that smoking Ն10 cigarettes per day affects glucose homeostasis in the direction of GDM (10). In contrast, no association between cigarette smoking and GDM was observed in a cross-sectional study of 10,000 maternity patients in New...

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Effect of cigarette smoking and of a transdermal nicotine delivery system on glucoregulation in type 2 diabetes mellitus

Cited by 46 publications

References 45 publications

A systematic review of possible serious adverse health effects of nicotine replacement therapy

A systematic review of possible serious adverse health effects of nicotine replacement therapy

Interaction between heavy smoking and CYP2A6 genotypes on type 2 diabetes and its possible pathways

Cigarette Smoking and the Risk of Gestational and Pregestational Diabetes in Two Consecutive Pregnancies

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