Impact of stopping smoking on metabolic parameters in diabetes mellitus: A scoping review

doi:10.4239/wjd.v13.i6.422

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World Journal of Diabetes

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Evidence Review

World J Diabetes. Jun 15, 2022; 13(6): 422-433
Published online Jun 15, 2022. doi: 10.4239/wjd.v13.i6.422

Impact of stopping smoking on metabolic parameters in diabetes mellitus: A scoping review

Magdalena Walicka, Cristina Russo, Michael Baxter, Isaac John, Grazia Caci, Riccardo Polosa

Magdalena Walicka, Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw 02-106, Poland

Magdalena Walicka, Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, Warsaw 02-507, Poland

Magdalena Walicka, Riccardo Polosa, Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy

Cristina Russo, Michael Baxter, Isaac John, Ashford and Saint Peter's Hospitals NHS Foundation Trust, Chertsey KT16 0PZ, United Kingdom

Grazia Caci, Department of Clinical and Experimental Medicine, University of Messina, Messina 98124, Italy

Riccardo Polosa, Center of Excellence for The Acceleration of HArm Reduction (CoEHAR), University of Catania, Cataia 95123, Italy

Riccardo Polosa, Centre for The Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico-V. Emanuele", Catania 95123, Italy

Riccardo Polosa, ECLAT Srl, Spin-off of the University of Catania, Catania 95123, Italy

Author contributions: Walicka M contributed to the conceptualization, literature search, and screening, writing, review, editing; Russo C, Baxter M and John I contributed to the writing, reviewing, editing; Caci G performed the literature search and screening, writing, reviewing, editing; Polosa R contributed to the conceptualization, writing, reviewing, editing, revising, supervising; all author read and approved the final version of the manuscript.

Supported by Department of Clinical and Experimental Medicine of the University of Catania, No. 6C813202024/1_3_02_07_01/2020.

Conflict-of-interest statement: RP is full tenure professor of Internal Medicine at the University of Catania (Italy). RP has received lecture fees and research funding from Pfizer, GlaxoSmithKline, CV Therapeutics, NeuroSearch A/S, Sandoz, MSD, Boehringer Ingelheim, Novartis, Duska Therapeutics, and Forest Laboratories. RP has also received grants from European Commission initiatives (U-BIOPRED and AIRPROM) and from the Integral Rheumatology & Immunology Specialists Network (IRIS) initiative. He has also served as a consultant for Pfizer, Global Health Alliance for treatment of tobacco dependence, CV Therapeutics, Boehringer Ingelheim, Novartis, Duska Therapeutics, ECITA (Electronic Cigarette Industry Trade Association, in the UK), Arbi Group Srl., Health Diplomats, and Sermo Inc. RP has served on the Scientific Advisory Board of Cordex Pharma, Inc., CV Therapeutics, Duska Therapeutics Inc, Pfizer, and PharmaCielo. RP is also founder of the Center for Tobacco prevention and treatment (CPCT) at the University of Catania and of the Center of Excellence for the acceleration of HArm Reduction (CoEHAR) at the same University, which has received support from FSFW to conduct 8 independent investigator-initiated research projects on harm reduction. RP has filed a patent application concerning an app tracker for smoking behaviour developed for ECLAT Srl. RP is involved in the following pro bono activities: scientific advisor for LIAF, Lega Italiana Anti Fumo (Italian acronym for Italian Anti-Smoking League), the Consumer Advocates for Smoke-free Alternatives (CASAA) and the International Network of Nicotine Consumers Organizations (INNCO); Chair of the European Technical Committee for standardization on “Requirements and test methods for emissions of electronic cigarettes” (CEN/TC 437; WG4). All other authors have no declared relevant conflict of interest to declare in relation to this study.

Corresponding author: Magdalena Walicka, MD, PhD, Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Adolfa Pawińskiego 5, Warsaw 02-106, Poland. m_walicka@wp.pl

Received: December 20, 2021
Peer-review started: December 20, 2021
First decision: April 18, 2022
Revised: May 1, 2022
Accepted: May 21, 2022
Article in press: May 21, 2022
Published online: June 15, 2022
Processing time: 169 Days and 14.2 Hours

Abstract

The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes. It is generally well accepted that smoking enhances the harmful effects of elevated blood glucose levels, accelerating the vascular damage seen in patients with diabetes. Smoking cessation has clear benefits in terms of reducing cardiovascular morbidity and mortality. However, there is less evidence for the impact of smoking cessation on other diabetes-related complications. Studies in people with diabetes have shown improvement as well as temporary deterioration in glycemic control after ceasing smoking. Only a few studies have described the effect of quitting smoking on insulin resistance and lipid parameters, however, their results have been inconclusive. In this situation, healthcare professionals should not assume that cessation of smoking will improve metabolic parameters in patients with diabetes. It seems they should, first of all, emphasize the prevention of weight gain that may be associated with quitting smoking. The lack of data regarding the metabolic effects of smoking and smoking cessation in diabetes is very disappointing and this area needs to be addressed.

Keywords: Smoking; Smoking cessation; Diabetes; Insulin resistance; Glucose; Lipids

Core Tip: Results of the studies regarding the impact of smoking cessation on metabolic parameters in patients with diabetes are inconsistent. Healthcare professionals should not assume that metabolic parameters in patients with diabetes who stop smoking will improve. It seems that the top priority after smoking cessation should be the prevention of weight gain. Further studies of the effects of quitting smoking on metabolic parameters among people with diabetes are required to provide an evidence base for healthcare advice to managed patients and to assist healthcare providers to implement the most effective interventions.