Aim
The relations between smoking and glycaemic parameters are not well explored. We compare HbA1c, fasting plasma glucose (FPG) and 2-hour plasma glucose (2H-PG) in current-, ex- and never-smokers.
Methods
This meta-analysis used individual data from 16 886 men and 18 539 women without known diabetes, in 12 DETECT-2 consortium studies and in the French D.E.S.I.R. and TELECOM studies. Means of the three glycaemic parameters in current-, ex- and never-smokers were modelled by linear regression, with study as a random factor. The I2 statistic evaluated heterogeneity among studies.
Results
HbA1c was 0.10 (95%CI:0.08,0.12) % [1.1 (0.9,1.3) mmol/mol] higher in current-smokers and 0.03 (0.01,0.05) % [0.3 (0.1,0.5) mmol/l] higher in ex-smokers, compared with never-smokers. For FPG, there was no significant difference between current- and never-smokers: −0.004 (−0.03,0.02) mmol/l but FPG was higher in ex-smokers: 0.12 (0.09,0.14) mmol/l. In comparison to never-smokers, 2H-PG was lower: −0.44 (−0.52,−0.37) mmol/l in current-smokers, with no difference for ex-smokers: 0.02 (−0.06,0.09) mmol/l. There was a large and unexplained heterogeneity among studies, with I2 always higher than 50%: after stratification by sex and adjustment for age and BMI, I2 changed little. In this study population, current-smokers had a prevalence of diabetes as screened by HbA1c, 1.30% higher and that screened by 2H-PG, 0.52% lower than in comparison to never-smokers.
Conclusion
Current-smokers had a higher HbA1c and a lower 2H-PG than never-smokers, across this heterogeneous group of studies; this will effect the chances of smokers being diagnosed with diabetes.