Association of smoking cessation after new-onset type 2 diabetes with overall and cause-specific mortality among Korean men: a nationwide population-based cohort study

IntroductionThis study aimed to examine the association between smoking cessation after new-onset type 2 diabetes and overall and cause-specific mortality risks among Korean men.Research design and methodsThe Korean National Health Insurance Service-National Health Screening Cohort database was searched, and 13 377 Korean men aged ≥40 years diagnosed with new-onset type 2 diabetes between 2004 and 2007 were included and followed up until 2013. We defined smoking status changes by comparing participants’ answers in the last survey before diagnosis to those in the first survey after diagnosis. We estimated the adjusted HR (AHR) and 95% CI for mortality risk using multivariable Cox proportional hazards regression models.ResultsWe identified 1014 all-cause mortality events (cancer, n=406 and cardiovascular disease (CVD), n=184) during an average follow-up duration of 7.2 years. After adjustment for all confounding factors, the reduced risk of all-cause mortality was more significant among short-term quitters (AHR 0.78; 95% CI 0.64 to 0.95), long-term quitters (AHR 0.68; 95% CI 0.54 to 0.85), and never smokers (AHR 0.66; 95% CI 0.56 to 0.78) compared with current smokers (p for trend <0.001). The lower risk of mortality from cancer was significant among the short-term quitters (AHR 0.60; 95% CI 0.44 to 0.83), long-term quitters (AHR 0.67; 95% CI 0.46 to 0.90), and never smokers (AHR 0.50; 95% CI 0.39 to 0.65) compared with current smokers (p for trend <0.001). There was no significant association between changes in smoking status and death from CVD. Smoking cessation after diagnosis in non-obese individuals (AHR 0.73; 95% CI 0.58 to 0.92) and exercisers (AHR 0.54; 95% CI 0.38 to 0.76) was significantly associated with reduced mortality risk than current smoking.ConclusionsSmoking cessation after new-onset type 2 diabetes was associated with reduced mortality risk.

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Long‐Term Mortality Associated With Use of Carvedilol Versus Metoprolol in Heart Failure Patients With and Without Type 2 Diabetes: A Danish Nationwide Cohort Study

Journal of the American Heart Association ◽

10.1161/jaha.121.021310 ◽

2021 ◽

Vol 10 (18) ◽

Author(s):

Brian Schwartz ◽

Colin Pierce ◽

Christian Madelaire ◽

Morten Schou ◽

Søren Lund Kristensen ◽

...

Keyword(s):

Heart Failure ◽

Type 2 Diabetes ◽

Mortality Benefit ◽

Reduced Ejection Fraction ◽

All Cause Mortality ◽

Long Term Mortality ◽

New Onset

Background Carvedilol may have favorable glycemic properties compared with metoprolol, but it is unknown if carvedilol has mortality benefit over metoprolol in patients with type 2 diabetes (T2D) and heart failure with reduced ejection fraction (HFrEF). Methods and Results Using Danish nationwide databases between 2010 and 2018, we followed patients with new‐onset HFrEF treated with either carvedilol or metoprolol for all‐cause mortality until the end of 2018. Follow‐up started 120 days after initial HFrEF diagnosis to allow initiation of guideline‐directed medical therapy. There were 39 260 patients on carvedilol or metoprolol at baseline (mean age 70.8 years, 35% women), of which 9355 (24%) had T2D. Carvedilol was used in 2989 (32%) patients with T2D and 10 411 (35%) of patients without T2D. Users of carvedilol had a lower prevalence of atrial fibrillation (20% versus 35%), but other characteristics appeared well‐balanced between the groups. Totally 11 306 (29%) were deceased by the end of follow‐up. We observed no mortality differences between carvedilol and metoprolol, multivariable‐adjusted hazard ratio (HR) 0.97 (0.90–1.05) in patients with T2D versus 1.00 (0.95–1.05) for those without T2D, P for difference =0.99. Rates of new‐onset T2D were lower in users of carvedilol versus metoprolol; age, sex, and calendar year adjusted HR 0.83 (0.75–0.91), P <0.0001. Conclusions In a contemporary clinical cohort of HFrEF patients with and without T2D, carvedilol was not associated with a reduction in long‐term mortality compared with metoprolol. However, carvedilol was associated with lowered risk of new‐onset T2D supporting the assertion that carvedilol has a more favorable metabolic profile than metoprolol.

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Association of sleep disturbance with risk of cardiovascular disease and all-cause mortality in patients with new-onset type 2 diabetes: data from the Korean NHIS-HEALS

Cardiovascular Diabetology ◽

10.1186/s12933-020-01032-5 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Young Choi ◽

Jae Woo Choi

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Sleep Disturbance ◽

Onset Type ◽

All Cause Mortality ◽

New Onset

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Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus

Diabetes & Metabolism Journal ◽

10.4093/dmj.2017.41.4.284 ◽

2017 ◽

Vol 41 (4) ◽

pp. 284 ◽

Cited By ~ 4

Author(s):

Kyoung Jin Kim ◽

Ju Hee Choi ◽

Kyeong Jin Kim ◽

Jee Hyun An ◽

Hee Young Kim ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Onset Type ◽

New Onset

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Poor Control of Plasma Triglycerides Is Associated with Early Decline of Estimated Glomerular Filtration Rates in New-Onset Type 2 Diabetes in China: Results from a 3-Year Follow-Up Study

Journal of Diabetes Research ◽

10.1155/2020/3613041 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Chuan Wang ◽

Lingshu Wang ◽

Kai Liang ◽

Fei Yan ◽

Xinguo Hou ◽

...

Keyword(s):

Type 2 Diabetes ◽

Blood Glucose ◽

Kidney Function ◽

Renal Outcome ◽

Onset Type ◽

Follow Up Study ◽

New Onset

Objective. Diabetic kidney disease (DKD) is the most common cause of end-stage renal disease (ESRD). Even after strict control of obesity, hyperglycemia, and hypertension, some patients still progress rapidly. Previous studies suggested diabetic dyslipidemia might be one of the factors responsible for this high residual risk. This study aims to explore the impact of long-term lipid control on renal outcome in new-onset type 2 diabetes mellitus (T2DM). Methods. We conducted a 3-year follow-up study, involving 283 subjects with new-onset T2DM, and observed the effect of baseline and follow-up metabolic abnormalities, especially dyslipidemia, on the early damage of kidney function using multiple logistic regression analysis. Results. After 3 years follow-up, patients achieved a better control of body weight, hypertension, and blood glucose. The most reduced eGFR group shared the least reduced BMI and LDL-C, as well as the greatest increase in TG levels. Only TG in the follow-up, not any of the baseline data, nor obesity, blood glucose, BP, or LDL-C in the follow-up, was found to be significantly correlated with the most reduced eGFR. Compared with patients with constantly abnormal TG levels, the risks were even higher in the subjects who experienced a transition from normal TG to hypertriglyceridemia ( OR = 2.576 versus OR = 2.184 , after multiple adjustment), and by tight controlling of TG, patients started with abnormal baseline TG levels could reduce the risk of DKD progression to the same low levels as the TG-constantly-normal group. Conclusion. This study emphasized the importance of long-term TG control in East Asian patients with new-onset T2DM: TG control can delay the decline of kidney function in the early stage of DKD, and reversal of hypertriglyceridemia may undo the risks of the past. It is time to pay more attention to the control of TG in new-onset T2DM.

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Abstract 041: Smoking Cessation and Subsequent Risk of Type 2 Diabetes in Three Large Prospective Cohort Studies of Americans

Circulation ◽

10.1161/circ.137.suppl_1.041 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Yang Hu ◽

Geng Zong ◽

Gang Liu ◽

Molin Wang ◽

An Pan ◽

...

Keyword(s):

Type 2 Diabetes ◽

Smoking Cessation ◽

Weight Gain ◽

Weight Change ◽

Weight Control ◽

Smoking Status ◽

Health Study ◽

Quitting Smoking ◽

Never Smokers

Background: The inter-relationships between smoking cessation, subsequent weight change, and type 2 diabetes (T2D) risk remain to be characterized. Methods: We prospectively followed 153,123 U.S. men and women from the Health Professionals Follow-up Study (1988-2012), Nurses’ Health Study (NHS, 1984-2012), and NHS II (1991-2013). Participants were followed biennially for smoking status, weight change, and diabetes risk. Self-reported T2D was confirmed using a validated supplementary questionnaire. Results: Compared with current smokers, T2D risk among quitters significantly increased and peaked after 5-7 years of quitting, and gradually decreased along extended durations. With a mean quitting duration of 9.9 years, the multivariate-adjusted hazard ratio (HR; 95% confidence intervals [95% CI]) of T2D was 1.26 (1.14, 1.39) for recent quitters (≤6 consecutive years) and1.04 (0.95, 1.14) for longer-term quitters in three cohorts. The T2D risk approached that of never smokers after 30 years of quitting among older nurses. There was, on average, 5.5 kg weight gain within 6 years of smoking cessation whereas 2.2 kg was gained in the same period among current smokers. The weight change significantly modified the association of smoking cessation with T2D risk ( p for interaction = 0.04): for quitters without weight gain (≤0 kg), 0-5 kg weight gain, and ≥5 kg weight gain within 6 years of smoking cessation, the HRs (95% CIs) of T2D were 0.92(0.73, 1.14), 1.27(1.10, 1.46) and 1.47(1.29, 1.67), respectively, compared with current smokers. We estimated that for quitters who did not gain weight within the first 6 years, their T2D risk approached that of never smokers after 5 years of quitting. Weight change within 6 years of quitting explained 22% (14.8%, 30.1%) of the elevated risk of T2D. Conclusions: Weight gain after quitting smoking may significantly attenuate the benefits of smoking cessation by increasing T2D risk. Our findings underscore the importance of weight control after quitting in maximizing the benefits of smoking cessation.

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Smoking Status and Survival Among a National Cohort of Lung and Colorectal Cancer Patients

Nicotine & Tobacco Research ◽

10.1093/ntr/nty012 ◽

2018 ◽

Vol 21 (4) ◽

pp. 497-504 ◽

Cited By ~ 9

Author(s):

Sandra J Japuntich ◽

Pallavi Kumar ◽

Jane F Pendergast ◽

Grelda Yazmin Juarez Caballero ◽

Jennifer L Malin ◽

...

Keyword(s):

Colorectal Cancer ◽

Smoking Cessation ◽

Mortality Risk ◽

Smoking Status ◽

Tumor Biology ◽

Lower Mortality ◽

Term Survival ◽

Never Smokers ◽

Lower Mortality Risk

Abstract Introduction The purpose of this study was to explore the association of smoking status and clinically relevant duration of smoking cessation with long-term survival after lung cancer (LC) or colorectal cancer (CRC) diagnosis. We compared survival of patients with LC and CRC who were never-smokers, long-term, medium-term, and short-term quitters, and current smokers around diagnosis. Methods We studied 5575 patients in Cancer Care Outcomes Research and Surveillance (CanCORS), a national, prospective observational cohort study, who provided smoking status information approximately 5 months after LC or CRC diagnosis. Smoking status was categorized as: never-smoker, quit >5 years prior to diagnosis, quit between 1–5 years prior to diagnosis, quit less than 1 year before diagnosis, and current smoker. We examined the relationship between smoking status around diagnosis with mortality using Cox regression models. Results Among participants with LC, never-smokers had lower mortality risk compared with current smokers (HR 0.71, 95% CI 0.57 to 0.89). Among participants with CRC, never-smokers had a lower mortality risk as compared to current smokers (HR 0.79, 95% CI 0.64 to 0.99). Conclusions Among both LC and CRC patients, current smokers at diagnosis have higher mortality than never-smokers. This effect should be further studied in the context of tumor biology. However, smoking cessation around the time of diagnosis did not affect survival in this sample. Implications The results from our analysis of patients in the CanCORS consortium, a large, geographically diverse cohort, show that both LC and CRC patients who were actively smoking at diagnosis have worse survival as compared to never-smokers. While current smoking is detrimental to survival, cessation upon diagnosis may not mitigate this risk.

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Mortality risk in people with type 2 diabetes: a large prospective population-based cohort study (The Ayrshire Diabetes fOllow-up Cohort (ADOC) study)

10.21203/rs.3.rs-35929/v1 ◽

2020 ◽

Author(s):

Andrew Collier ◽

Mario Hair ◽

Lyall Cameron ◽

Sujoy Ghosh ◽

James Boyle ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mortality Risk ◽

Smoking Status ◽

Economic Status ◽

Hdl Cholesterol ◽

Population Based ◽

Risk Difference ◽

All Cause Mortality ◽

Low Hdl

Abstract BackgroundThe aims of this study were to investigate the effects of age, gender, body mass index (BMI), glycaemic control, socio-economic status, dyslipidaemia, hypertension, ischaemic heart disease (IHD) and smoking status in type 2 diabetes in a population-based analysis. MethodsData were collected from 46 General Practice databases in 2009 and 2014. Cox regressions were run in the non-diabetes population plus type 2 diabetes patients. ResultsPeople with type 2 diabetes (n=16,643) had higher mortality rates than non-diabetes subjects. Ranked in order of Hazard Ratio (HR), increasing age (HR 2.31), smoking (HR 1.79), IHD (HR 1.65), deprivation (HR 1.36), hypertension (HR 1.23) and male gender (HR 1.20) all increased mortality risk (p<0.01). Statin therapy was associated with better outcome (HR 0.65, p<0.01). Abnormal lipid levels whilst not on a statin significantly increased mortality risk for raised total-cholesterol (HR 1.74) and low HDL-cholesterol (HR 1.48) but not for triglycerides (HR 0.67) (all p<0.01). ConclusionsThis large study confirmed that the all-cause mortality risk in people with type 2 diabetes remains elevated. In the study we demonstrated that a man with type 2 diabetes of 5-10 years duration who smoked, had hypertension and IHD plus lived in the most deprived area had a HR of 6.2 compared with a non-smoking, normotensive, non-diabetes subject without IHD living in the least deprived area. . Further research is required to understand the gender risk difference in all-cause mortality in type 1 compared with type 2 diabetes and why obesity plus raised triglycerides appear to be protective.

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