Smoking and diabetes interplay: A comprehensive review and joint statement

Durlach, V.; Vergès, Bruno; Al-Salameh, Abdallah; Bahougne, Thibault; Benzerouk, Farid; Berlin, Ivan; Clair, Carole; Mansourati, Jacques; Rouland, Alexia; Thomas, Daniel; Thuillier, Philippe; Tramunt, Blandine; Faou, Anne-Laurence Le

doi:10.1016/j.diabet.2022.101370

Cited by 60 publications

(38 citation statements)

References 103 publications

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“…The significantly raised risk of liver and kidney cancers, and non-significantly raised risks of colorectal, pancreatic and endometrial cancers and non-Hodgkin lymphoma, accord with raised risks of these tumours generally found in type 2 cohorts 1-5 and, with the exception of non-Hodgkin lymphoma, generally also in nominally type 1 cohorts. 5,[8][9][10][11][12] Likewise, the significantly reduced risk of prostate cancer in patients with diabetes diagnosed at older ages in our cohort accords with reduced risk in type 2 diabetes cohorts [1][2][3][4][5] 39 and smoking prevalence 40 Our study of type 1 diabetes patients had several strengths-large size; information to allow analyses by age at diagnosis of diabetes (not published for any other cohort, except for one publication on a twoway split of ages for three cancer sites 10 ); high completeness of follow-up; longer follow-up than any study previously; information on cancer mortality as well as incidence; and restriction to insulin-treated patients. However, it is a weakness that, like most other cohorts, we did not have direct data on diabetes type: for the diabetes onset under age 30 group, the effect should have been minor, since we estimate about 94% will have been type 1, but for the comparison group of patients diagnosed at ages 30 to 49, the effect will have been of greater impact since only about 68% would have been type 2.…”

Section: Discussionsupporting

confidence: 71%

“…The results on risk by duration since diabetes onset in our cohort gave no indication of relations other than for ovarian and vulval cancer risks in patients with diabetes onset before age 30, which reached a peak and then diminished, and lung cancer in patients with diabetes onset at ages 30 and older. The latter diminished consistently with longer follow up, and may indicate selective early mortality of heavy smokers with diabetes (which we estimate based on published data on mortality 39 and smoking prevalence 40 in patients with diabetes might have reduced the proportion of heavy smokers in the denominator by about 40%), and/or younger smoking cessation in patients with diabetes, and hence exceptionally low smoking levels in those surviving to later years. With the exception of two cases of melanoma, there was no indication of raised cancer risk soon after the start of follow up, which could indicate cancer diagnoses as a consequence of clinical workup for diabetes or vice versa.…”

Section: Discussionmentioning

confidence: 78%

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Cancer incidence and mortality in 23 000 patients with type 1 diabetes in the UK: Long‐term follow‐up

Swerdlow

Jones

Slater³

et al. 2023

Intl Journal of Cancer

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Type 2 diabetes is associated with raised risk of several cancers, but for type 1 diabetes risk data are fewer and inconsistent We assembled a cohort of 23 473 UK patients with insulin-treated diabetes diagnosed at ages <30, almost all of whom will have had type 1 diabetes, and for comparison 5058 diagnosed at ages 30 to 49, of whom we estimate two-thirds will have had type 2, and followed them for an average of 30 years for cancer incidence and mortality compared with general population rates. Patients aged <30 at diabetes diagnosis had significantly raised risks only for ovarian (standardised incidence ratio = 1.58; 95% confidence interval 1.16-2.11; P < .01) and vulval (3.55; 1.94-5.96; P < .001) cancers, with greatest risk when diabetes was diagnosed at ages 10-14. Risks of cancer overall (0.89; 0.84-0.95; P < .001) and sites including lung and larynx were significantly diminished. Patients diagnosed with diabetes at ages 30 to 49 had significantly raised risks of liver (1.76;1.08-2.72) and kidney (1.46;1.03-2.00) cancers, and reduced risk of cancer overall (0.89; 0.84-0.95). The raised ovarian and vulval cancer risks in patients with type 1 diabetes, especially with diabetes diagnosed around pubertal ages, suggest possible susceptibility of these organs at puberty to metabolic disruption at diabetes onset. Reduced risk of cancer overall, particularly smoking and alcohol-related sites, might reflect adoption of a healthy lifestyle.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 78%

Cancer incidence and mortality in 23 000 patients with type 1 diabetes in the UK: Long‐term follow‐up

Swerdlow

Jones

Slater³

et al. 2023

Intl Journal of Cancer

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“…Similarly, in the United States, diabetes rates are higher in rural areas than in urban areas ( 18 ). Previous studies have also demonstrated that smoking increases the risk of prediabetes and diabetes in the general population ( 19 ). In addition, alcohol abuse is associated with an increased risk of diabetes, while low-to-moderate consumption of wine may have beneficial effects ( 20 ).…”

Section: Discussionmentioning

confidence: 95%

Regular consumption of pickled vegetables and fermented bean curd reduces the risk of diabetes: a prospective cohort study

Cai

Yang

Chen

et al. 2023

Front. Public Health

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ObjectiveThe global incidence of diabetes is rising, in part due to the widespread adoption of poor dietary habits. Fermented vegetables have numerous health benefits and are generally affordable. Here, we examined whether regular consumption of pickled vegetables or fermented bean curd reduces the risk of diabetes.MethodsA total of 9,280 adults (≥18 years of age) were recruited via multi-stage sampling from 48 townships in China between 2010 and 2012 for this 10-year prospective study. In addition to demographic information, monthly consumption levels of pickled vegetables and fermented bean curd were recorded. Participants were then monitored for diabetes onset. After the final follow-up, logistic regression analyses with multiple covariant corrections were conducted to estimate the changes in diabetes risk associated with consumption of pickled vegetables and fermented bean curd compared to non-consumption.ResultsA total of 6,640 subjects without diabetes at the start of the study were followed up for a median period of 6.49 years, among whom 714 were diagnosed with diabetes during the study. According to a regression model with multivariable adjustment, diabetes risk was significantly reduced by consumption of 0–0.5 kg/month of pickled vegetables (OR = 0.77, 95% CI: 0.63, 0.94) and further reduced by consumption of >0.5 kg/month of pickled vegetables (OR = 0.37, 95% CI: 0.23, 0.60) compared to no consumption (both P-trend < 0.001). Consumption of fermented bean curd also reduced diabetes risk (OR = 0.68, 95% CI: 0.55, 0.84).ConclusionRegular consumption of pickled vegetables and/or fermented bean curd can reduce the long-term risk of diabetes.

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“…It is well known that cigarette smoking is associated with an increased risk of cardiovascular disease, including for patients with T2D. 1,2,21,22 However, in the current study, cigarette smoking was not associated with an increased Differences between smoking statuses were tested using a two-sided Mann-Whitney U test for continuous variables and a x 2 test for categorical variables. Antihypertensives included angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, loop diuretics and beta blockers.…”

Section: Discussionmentioning

confidence: 59%

Smoking and cardiovascular disease in patients with type 2 diabetes: a prospective observational study

af Geijerstam,

Janryd,

Nyström

2023

Journal of Cardiovascular Medicine

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Background Cigarette smoking is a major risk factor for cardiovascular disease. In type 2 diabetes mellitus (T2D), medications such as antihypertensives and statins can reduce the increased cardiovascular risk. The aim of this study was to evaluate the impact of cigarette smoking on major adverse cardiovascular event (MACE) and all-cause mortality in patients with T2D in a relatively well treated Swedish cohort. Methods Seven hundred and sixty-one patients with T2D aged 55–66 years were followed in the prospective observational CArdiovascular Risk factors in patients with DIabetes – a Prospective study in Primary care (CARDIPP) study. Baseline data included blood samples of markers of dysglycemia and inflammation, blood pressure as well as questionnaire responses regarding cigarette smoking. Participants were followed for incidence of MACE and all-cause mortality. Results Of the included 663 participants, the mean age was 60.6 (SD 3.1) years and 423 (63.8%) were men. Levels of C-reactive protein and vitamin D, as well as the proportion of participants treated with antihypertensives, acetylic salicylic acid, statins, and diabetes medications, were similar between smokers and nonsmokers. Median follow-up time was 11.9 (Q1–Q3 10.8–12.7) years. Cigarette smoking was associated with all-cause mortality [hazard ratio 2.24 (95% confidence interval, 95% CI 1.40–3.56), P < 0.001], but not MACE [hazard ratio 1.30 (95% CI 0.77–2.18), P = 0.328]. Conclusion In patients with T2D, cigarette smoking was not associated with an increased risk of MACE. This raises the question of whether cardioprotective drugs in individuals with T2D to some degree mitigate the cardiovascular harm of smoking, even though they do not affect other dire consequences of smoking.

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Smoking and diabetes interplay: A comprehensive review and joint statement

Cited by 60 publications

References 103 publications

Cancer incidence and mortality in 23 000 patients with type 1 diabetes in the UK: Long‐term follow‐up

Cancer incidence and mortality in 23 000 patients with type 1 diabetes in the UK: Long‐term follow‐up

Regular consumption of pickled vegetables and fermented bean curd reduces the risk of diabetes: a prospective cohort study

Smoking and cardiovascular disease in patients with type 2 diabetes: a prospective observational study

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