Varenicline in smokers with diabetes: A pooled analysis of 15 randomized, placebo‐controlled studies of varenicline

Tonstad, Serena; Lawrence, David

doi:10.1111/jdi.12543

Cited by 36 publications

(24 citation statements)

References 34 publications

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“…Numerous large randomized clinical trials have demonstrated the efficacy and cost-effectiveness of brief counseling in smoking cessation, including the use of telephone quit lines, in reducing tobacco use. Pharmacologic therapy to assist with smoking cessation in people with diabetes has been shown to be effective (172), and for the patient motivated to quit, the addition of pharmacologic therapy to counseling is more effective than either treatment alone (173). Special considerations should include assessment of level of nicotine dependence, which is associated with difficulty in quitting and relapse (174).…”

Section: Diabetic Kidney Diseasementioning

confidence: 99%

5. Lifestyle Management:Standards of Medical Care in Diabetes—2019

2018

Diabetes Care

568

279

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The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidencegrading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC. Lifestyle management is a fundamental aspect of diabetes care and includes diabetes self-management education and support (DSMES), medical nutrition therapy (MNT), physical activity, smoking cessation counseling, and psychosocial care. Patients and care providers should focus together on how to optimize lifestyle from the time of the initial comprehensive medical evaluation, throughout all subsequent evaluations and follow-up, and during the assessment of complications and management of comorbid conditions in order to enhance diabetes care. DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT Recommendations 5.1 In accordance with the national standards for diabetes self-management education and support, all people with diabetes should participate in diabetes self-management education to facilitate the knowledge, skills, and ability necessary for diabetes self-care. Diabetes self-management support is additionally recommended to assist with implementing and sustaining skills and behaviors needed for ongoing self-management. B 5.2 There are four critical times to evaluate the need for diabetes selfmanagement education and support: at diagnosis, annually, when complicating factors arise, and when transitions in care occur. E 5.3 Clinical outcomes, health status, and quality of life are key goals of diabetes self-management education and support that should be measured as part of routine care. C 5.4 Diabetes self-management education and support should be patient centered, may be given in group or individual settings or using technology, and should be communicated with the entire diabetes care team. A 5.5 Because diabetes self-management education and support can improve outcomes and reduce costs B, adequate reimbursement by third-party payers is recommended. E

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Section: Diabetic Kidney Diseasementioning

confidence: 99%

5. Lifestyle Management:Standards of Medical Care in Diabetes—2019

2018

Diabetes Care

568

279

View full text Add to dashboard Cite

show abstract

“…Numerous large randomized clinical trials have demonstrated the efficacy and costeffectiveness of brief counseling in smoking cessation, including the use of telephone quit lines, in reducing tobacco use. Pharmacologic therapy to assist with smoking cessation in people with diabetes has been shown to be effective (188), and for the patient motivated to quit, the addition of pharmacologic therapy to counseling is more effective than either treatment alone (189). Special considerations should include assessment of level of nicotine dependence, which is associated with difficulty in quitting and relapse (190).…”

Section: Diabetic Kidney Diseasementioning

confidence: 99%

5. Facilitating Behavior Change and Well-being to Improve Health Outcomes:Standards of Medical Care in Diabetes—2020

2019

Diabetes Care

286

133

View full text Add to dashboard Cite

The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10 .2337/dc20-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes .org/SOC. Effective behavior management and psychological well-being are foundational to achieving treatment goals for people with diabetes (1,2). Essential to achieving these goals are diabetes self-management education and support (DSMES), medical nutrition therapy (MNT), routine physical activity, smoking cessation counseling when needed, and psychosocial care. Following an initial comprehensive medical evaluation (see Section 4, "Comprehensive Medical Evaluation and Assessment of Comorbidities," https://doi.org/10.2337/dc20-S004), patients and providers are encouraged to engage in person-centered collaborative care (3-6), which is guided by shared decision-making in treatment regimen selection, facilitation of obtaining needed medical and psychosocial resources, and shared monitoring of agreed-upon regimen and lifestyle (7). Re-evaluation during routine care should include not only assessment of medical health but also behavioral and mental health outcomes, especially during times of deterioration in health and well-being. DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT Recommendations 5.1 In accordance with the national standards for diabetes self-management education and support, all people with diabetes should participate in diabetes self-management education and receive the support needed to facilitate the knowledge, decision-making, and skills mastery necessary for diabetes selfcare. A 5.2 There are four critical times to evaluate the need for diabetes selfmanagement education to promote skills acquisition in support of regimen Suggested citation: American Diabetes Association. 5. Facilitating behavior change and wellbeing to improve health outcomes:

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“…There is a dearth of evidence of efficacy on tailored smoking interventions for diabetic patients (Nagrebetsky, Brettell, Roberts, & Farmer, ). However, a retrospective pooled analysis of 15 RCTs examining the efficacy of the smoking cessation drug varenicline in smokers with diabetes showed a higher abstinence rate in the intervention arm compared to the placebo group at 3 months (43.8% and 24.8%, respectively) (Tonstad & Lawrence, ). The abstinence rate markedly declined to 18.4% after 1‐year follow‐up in the varenicline‐treated group (Tonstad & Lawrence, ), suggesting short‐term benefit.…”

Section: Introductionmentioning

confidence: 99%

“…However, a retrospective pooled analysis of 15 RCTs examining the efficacy of the smoking cessation drug varenicline in smokers with diabetes showed a higher abstinence rate in the intervention arm compared to the placebo group at 3 months (43.8% and 24.8%, respectively) (Tonstad & Lawrence, ). The abstinence rate markedly declined to 18.4% after 1‐year follow‐up in the varenicline‐treated group (Tonstad & Lawrence, ), suggesting short‐term benefit. Psychotherapeutic approaches to quit smoking in people with diabetes showed a success rate between 17%–50% (Canga et al., ; Hokanson, Anderson, Hennrikus, Lando, & Kendall, ; Persson & Hjalmarson, ; Thankappan et al., ).…”

Section: Introductionmentioning

confidence: 99%