Additional file 1: Database Search - EMBASE/CINAH

Clare Gillies (3411524)

David Webb (294780)

Debasish Kar (3411521)

Francesco Zaccardi (285809)

Kamlesh Khunti (171607)

Melanie Davies (545715)

Samuel Seidu (3411518)

Solomon Tesfaye (562907)

PubMed

Debasish Kar

Clare Gillies

Francesco Zaccardi

David Webb

Samuel Seidu

Solomon Tesfaye

Melanie Davies

Kamlesh Khunti

Crossref

Cardiovascular Diabetology

Relationship of cardiometabolic parameters in non-smokers, current smokers, and quitters in diabetes: a systematic review and meta-analysis

BACKGROUND: Smoking is associated with increased macrovascular and microvascular complications in people with diabetes. In addition to other concomitant vascular perturbations, it also seems to influence the cardiometabolic parameters, which may partly explain the accelerated rate of vascular complications in smokers with diabetes. While smoking cessation is advocated as a universal component of the management of diabetes, there is some anecdotal evidence that HbA1c could increase following smoking cessation. The aim of this review is to explore the relationship between smoking and its cessation on cardiometabolic parameters in diabetes. METHODS: Searches were conducted on Medline, EMBASE and CINAHL up to March 2016. After screening 6866 studies (Additional file 1), 14 observational studies with a total of 98,978 participants' with either type 1 or type 2 diabetes were selected for review. Narrative synthesis and meta-analyses were carried out to explore the relationship between smoking and its cessation. RESULTS: Meta-analysis showed that the pooled mean difference of HbA1c between non-smokers and smokers was -0.61% (95% CI -0.88 to -0.33, p < 0.0001). The difference in LDL cholesterol between non-smokers and smokers was -0.11 mmol/l (95% CI -0.21 to -0.01, p = 0.04). The difference in HDL cholesterol between non-smokers and smokers was 0.12 mmol/l (95% CI 0.08-0.15, p < 0.001). However, there was no statistically significant difference in blood pressure between the two groups. The difference in HbA1c between quitters and continued smokers was not statistically significant -0.10% (95% CI -0.42 to 0.21, p = 0.53). However, a narrative synthesis revealed that over a period of 10 years, the HbA1c was comparable between non-smokers and quitters. CONCLUSION: Non-smokers have a statistically significant lower HbA1c and more favourable lipid profile compared to smokers. Smoking cessation does not lead to an increase in HbA1c in long-term and may reduce vascular complications in diabetes by its favourable impact on lipid profile

Kar, D

Gillies, C

Zaccardi, F

Webb, D

Seidu, S

Tesfaye, S

Davies, M

Khunti, K

University of Melbourne Institutional Repository

Background: Smoking is associated with increased macrovascular and microvascular complications in people with

diabetes. In addition to other concomitant vascular perturbations, it also seems to influence the cardiometabolic

parameters, which may partly explain the accelerated rate of vascular complications in smokers with diabetes. While

smoking cessation is advocated as a universal component of the management of diabetes, there is some anecdotal

evidence that HbA1c could increase following smoking cessation. The aim of this review is to explore the relationship

between smoking and its cessation on cardiometabolic parameters in diabetes.

Methods: Searches were conducted on Medline, EMBASE and CINAHL up to March 2016. After screening 6866 studies

(Additional file 1), 14 observational studies with a total of 98,978 participants’ with either type 1 or type 2 diabetes

were selected for review. Narrative synthesis and meta-analyses were carried out to explore the relationship between

smoking and its cessation.

Results: Meta-analysis showed that the pooled mean difference of HbA1c between non-smokers and smokers was

−0.61% (95% CI −0.88 to −0.33, p < 0.0001). The difference in LDL cholesterol between non-smokers and smokers

was −0.11 mmol/l (95% CI −0.21 to −0.01, p = 0.04). The difference in HDL cholesterol between non-smokers and

smokers was 0.12 mmol/l (95% CI 0.08–0.15, p < 0.001). However, there was no statistically significant difference in

blood pressure between the two groups. The difference in HbA1c between quitters and continued smokers was not

statistically significant −0.10% (95% CI −0.42 to 0.21, p = 0.53). However, a narrative synthesis revealed that over a

period of 10 years, the HbA1c was comparable between non-smokers and quitters.

Conclusion: Non-smokers have a statistically significant lower HbA1c and more favourable lipid profile compared to

smokers. Smoking cessation does not lead to an increase in HbA1c in long-term and may reduce vascular complications

in diabetes by its favourable impact on lipid profile

Kar, D.

Gillies, C.

Zaccardi, F.

Webb, D.

Seidu, S.

Tesfaye, S.

Davies, M.

Khunti, K.

White Rose Research Online

Background
Smoking is associated with increased macrovascular and microvascular complications in people with diabetes. In addition to other concomitant vascular perturbations, it also seems to influence the cardiometabolic parameters, which may partly explain the accelerated rate of vascular complications in smokers with diabetes. While smoking cessation is advocated as a universal component of the management of diabetes, there is some anecdotal evidence that HbA1c could increase following smoking cessation. The aim of this review is to explore the relationship between smoking and its cessation on cardiometabolic parameters in diabetes.

Methods
Searches were conducted on Medline, EMBASE and CINAHL up to March 2016. After screening 6866 studies (Additional file 1), 14 observational studies with a total of 98,978 participants’ with either type 1 or type 2 diabetes were selected for review. Narrative synthesis and meta-analyses were carried out to explore the relationship between smoking and its cessation.

Results
Meta-analysis showed that the pooled mean difference of HbA1c between non-smokers and smokers was −0.61% (95% CI −0.88 to −0.33, p < 0.0001). The difference in LDL cholesterol between non-smokers and smokers was −0.11 mmol/l (95% CI −0.21 to −0.01, p = 0.04). The difference in HDL cholesterol between non-smokers and smokers was 0.12 mmol/l (95% CI 0.08–0.15, p < 0.001). However, there was no statistically significant difference in blood pressure between the two groups. The difference in HbA1c between quitters and continued smokers was not statistically significant −0.10% (95% CI −0.42 to 0.21, p = 0.53). However, a narrative synthesis revealed that over a period of 10 years, the HbA1c was comparable between non-smokers and quitters.

Conclusion
Non-smokers have a statistically significant lower HbA1c and more favourable lipid profile compared to smokers. Smoking cessation does not lead to an increase in HbA1c in long-term and may reduce vascular complications in diabetes by its favourable impact on lipid profile

Kar, Debasish

Gillies, Clare

Zaccardi, Francesco

Webb, David

Seidu, Samuel

Tesfaye, Solomon

Davies, Melanie

Khunti, Kamlesh

Oxford University Research Archive

English

S. Tesfaye (7716170)

Leicester Research Archive

Relationship of cardiometabolic parameters in non-smokers, current smokers, and quitters in diabetes: a systematic review and meta-analysis.

Additional file 3: Code for meta-regressio

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MOESM3 of Relationship of cardiometabolic parameters in non-smokers, current smokers, and quitters in diabetes: a systematic review and meta-analysis

Additional file 2: Database search - OVID/Medlin

MOESM2 of Relationship of cardiometabolic parameters in non-smokers, current smokers, and quitters in diabetes: a systematic review and meta-analysis

Yamada, Syuuji

Tanino, Tetsuzo

Inuiguchi, Masahiro

Kyoto University Research Information Repository