Metabolic Changes Following Smoking Cessation in Patients with Type 2 Diabetes Mellitus

Author:

Driva Stamatina123ORCID,Korkontzelou Aliki13ORCID,Tonstad Serena4,Tentolouris Nikolaos2,Litsiou Eleni1,Vasileiou Vasiliki5ORCID,Vassiliou Alice G.1ORCID,Saltagianni Vassiliki1,Katsaounou Paraskevi1ORCID

Affiliation:

1. Smoking Cessation Outpatient Clinic, Respiratory Department, First Intensive Care Unit, Evangelismos General Hospital, 10676 Athens, Greece

2. Diabetes Centre, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece

3. Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece

4. Department of Preventive Cardiology, Oslo University Hospital, 0424 Oslo, Norway

5. Endocrinology Department, Diabetes Center, Alexandra Hospital, 11528 Athens, Greece

Abstract

Background: Smoking cessation is crucial for reducing complications of type 2 diabetes mellitus (T2DM), but associated weight gain can worsen glycemic control, discouraging quitting attempts. Varenicline, a partial agonist of α4β2 nicotinic receptors, aids smoking cessation. This study examines the effects of varenicline on body weight and metabolic parameters in patients with T2DM and prediabetes. Methods: Fifty-three patients were enrolled, of which 32 successfully quit smoking after a three-month course of varenicline and were examined after an additional month with no medication. Measurements taken at baseline, 2.5 months, and 4 months included body weight, blood pressure, resting metabolic rate (RMR), glycated hemoglobin (HbA1c), fasting glucose, blood lipids, C-reactive protein (CRP), appetite-related hormones, and physical activity. Results: Post-treatment, there were no significant changes in body weight, blood pressure, RMR, or glycemic control. Total (CHOL) and low-density lipoprotein (LDL-C) cholesterol decreased significantly at 4 months of the study (from 168 to 156 mg/dL, p = 0.013, and from 96 to 83 mg/dL, p = 0.013, respectively). Leptin levels increased (from 11 to 13.8 ng/dL, p = 0.004), as did glucagon-like peptide-1 (GLP-1) levels (from 39.6 to 45.8 pM, p = 0.016) at 4 months of follow-up. The percentage of participants who reported moderate-intensity activity increased from 28% to 56%, while those reporting high-intensity activity increased from 19% to 22%, respectively (p = 0.039). Conclusions: Our study showed that smoking cessation with varenicline in smokers with T2DM and prediabetes led to significant improvements in lipid profile, significant increase in plasma leptin and GLP-1 levels, and increased physical activity, without significant weight gain. Thus, smoking cessation without weight gain or deteriorated glycemic control is feasible for these smokers, with added benefits to lipid profiles, GLP-1 regulation, and physical activity.

Funder

Global Research Awards for Nicotine Dependence

Publisher

MDPI AG

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