Vol 2, No 2 (2001): Practical Diabetology
Other materials agreed with the Editors
Published online: 2001-03-08
Smoking and diabetes
Diabetologia Praktyczna 2001;2(2):99-116.
Abstract
The objective of this review is to summarize the literature
on diabetes and smoking related to epidemiological
risks, efficacy and cost-effectiveness of
different cessation approaches, and implications for
clinical practice. Over 200 studies were reviewed,
with special emphasis placed on publications within
the past 10 years. Intervention studies that included
patients with diabetes but did not report
results separately by disease are included. Diabetesspecific
studies are highlighted. There are consistent
results from both cross-sectional and prospective
studies showing enhanced risk for micro- and macrovascular
disease, as well as premature mortality
from the combination of smoking and diabetes. The
general cessation literature is extensive, generally
well-designed, and encouraging regarding the impact
of cost-effective practical office-based interventions.
In particular, system-based approaches that
make smoking a routine part of office contacts and
provide multiple prompts, advice, assistance, and
follow-up support are effective. Although there is
minimal information on the effectiveness of cessation
interventions specifically for people with diabetes,
there is no reason to assume that cessation
intervention would be more or less effective in this
population. There is a clear need to increase the frequency
of smoking cessation advice and counseling
for patients with diabetes given the strong and consistent
data on smoking prevalence; combined risks
of smoking and diabetes for morbidity, mortality,
and several complications; and the proven efficacy
and cost-effectiveness of cessation strategies.
Keywords: smokingmicrovascular complicationsmacrovascular complications