Worse HbA1c, diabetes distress for current vs. former smokers with type 1 diabetes
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Among adults with type 1 diabetes, current tobacco users have worse diabetes-related outcomes vs. past users and those who have quit, according to study results published in Journal of Diabetes and Its Complications.
“This study found that current tobacco users tended to have worse profiles compared to never users across several clinical outcomes, including higher HbA1c values, higher diabetes distress scores, lower self-care scores and less frequent self-monitoring blood glucose,” Carla J. Rash, PhD, associate professor of medicine in the Calhoun Cardiology Center, Behavioral Cardiovascular Prevention Division and department of medicine at UConn Health, and colleagues wrote. “In contrast, former users were similar to never users on all these outcomes, suggesting that tobacco cessation may improve some clinical outcomes.”
Rash and colleagues administered standardized questionnaires to 933 adults (mean age, 38 years; median age at diagnosis, 13 years; 61% women; 90% non-Hispanic white adults; 83% with private insurance) included in the TID Exchange Registry. Among the participants, 18% reported current tobacco use (with 31% using daily), 27% past use and 55% never use. Among the current users, 10% used chewing tobacco and 13% used e-cigarettes; 69% reported daily use.
After controlling for age, race/ethnicity, type of insurance, continuous glucose monitoring use, pump use and site, HbA1c values were positively associated with tobacco use frequency. Mean HbA1c was higher for current users vs. never users (P .001), similar for past and never users, and higher for daily vs. less than daily users (P .002).
Similarly, self-care as assessed by Self-care Inventory-Revised and the Problem Areas in Diabetes Scale was worse for current tobacco users compared with never users, as were reported diabetes distress and frequency of SMBG (P .001 for all). No significant differences were observed for past and never users.
Current users had lower BMI z scores compared with those for never (P .001) and past users, who had similar scores.
“We identified a number of worse diabetes-related outcomes among current tobacco users with indications that these outcomes may have dose-related associations with intensity of tobacco use,” the researchers wrote. “Encouragingly, former tobacco users were largely similar to never users, suggesting that tobacco cessation may improve these diabetes-related outcomes. Tailored messaging and targeted prevention and intervention efforts are needed to further decrease tobacco use in this high-risk population.”
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