Aim: To evaluate the relationship between smoking and metabolic parameters in patients affected by type 1 diabetes (T1D)
Patients and methods: We enrolled 104 children and young adults (50 females and 54 males) with T1D (aged 16.4±8.6 years). The subjects were divided into three groups according to their smoking habits: no smoking (NS), passive smoking (PS), active smoking (AS). The physical examination of the participants included nutritional status assessment by anthropometry and pubertal stage according to Marshall and Tanner as well as blood pressure (BP) measurement. In all patients, metabolic blood assays including fasting blood glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, triglycerides were measured. Insulin resistance was determined by glucose disposal rate (eGDR). Physical activity was also recorded.
Results: Significant differences in biochemical and functional parameters among the three groups were demonstrated, in particular for systolic (P=0.002) and diastolic pressure (P=0.02) and eGDR (P=0.039). No differences in daily insulin dose (P=0.75) and glycosylated hemoglobin (P=0.39) were observed. AS group had significantly higher blood pressure (P<0.05) and lower eGDR (P≤0.001) compared to NS and PS. Significant difference was also detected between PS and NS in systolic and diastolic (P=0.02) pressure and eGDR (P=0.01). In a multivariable model adjusted for age, gender, BMI and physical activity, smoking habits maintained none independent association with metabolic parameters.
Conclusion: Our data support the relationship between smoking and an unfavorable cardio-metabolic profile in adolescents with T1D. On the basis of these findings, smoking tobacco should be considered an important modifiable risk factor for young patients with diabetes mellitus, highlighting the need for intensified smoking prevention and cessation programs.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology