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GPs urged to monitor blood glucose closely when patients with diabetes quit smoking 

GPs should monitor glycaemic control extra carefully in patients with diabetes who quit smoking, according to UK experts who found patients’ blood sugar increased after they gave up the habit – regardless of whether they put on weight.

The team’s study of UK general practice records found the patients’ worsened glucose control lasted for two-to-three years after quitting.

The study – which was funded by the National Institute for Health Research School for Primary Care Research and led by Dr Deborah Lycett at Coventry University – looked at over 10,500 adult smokers with type 2 diabetes whose records were included in The Health Improvement Network database of general practice.

Just over 3,100 of the patients (29%) quit smoking and remained abstinent for at least a year.

After taking into account potential confounders, including weight gain, patients had an average 2.29mmol/mol rise in their HbA1c levels during the first year after quitting.

Their HbA1c gradually fell again thereafter, but remained elevated for another two years when compared with continuing smokers.

The researchers concluded: ‘This study has shown strong evidence that glycaemic control worsens after cessation of smoking of smoking and that this does not appear to be primarily down to increases in bodyweight that usually follow cessation.

‘A proactive review of glycaemic control and prompt adjustment of medication is needed in this patient group both before and after smoking cessation.’

Lancet Diabetes Endocrinol 2015; available online 30 April

Readers' comments (8)

  • What about when the patient has an argument, comes back from a holiday, Tesco has a flash sale, the patient is upset after a break up? The sugars will rise due to life circumstances. Give GPs a break from the monotony and respect nature's way. Diabetes is a progressive condition researchers.

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  • Rephrase this as' patients advised to monitor their blood sugar after stopping smoking and be monitored by the practice nurse/nurse practitioner.
    We've got enough to do.

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  • Umm, 0.21% increase in average HbA1c. Please learn to statistic. Nothing to see here. Move on.

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  • "Rephrase this as' patients advised to monitor their blood sugar after stopping smoking"

    How are they supposed to do that exactly when GPs and CCGs withhold BG strips from T2 diabetics?

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  • A whole 2.29mmol/mol rise!

    This might be important in ivory-tower land but I don't think anyone in the real world will panic about this...

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  • Bob Hodges

    There's no evidence that that sort of rise in HbA1c has any impact on outcomes- neither mortality nor morbidity.

    This is the reason why Type 2 diabetics (who aren't on SU or Insulin) shouldn't be testing their blood sugars - it means nothing and only causes anxiety.

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  • can Jeremy hunt be tested for capacity

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  • Have they considered that many quitters "compensate" by an increase in food intake as their new "comforter"?
    This is almost assuredly going to lead to increase in blood glucose if only in the short term.

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