Smoking cessation in patients with Diabetes Mellitus (DM)

Smoking is associated with impaired fasting glucose levels and increased insulin resistance.Post-cessation weight gain (PSWG) highly concerns diabetic patients since it leads to poor control of diabetic parameters, discourages them to quit and can be a cause of relapse. Identification of this population9s characteristics could help improve smoking cessation rates. We recruited smokers with DM (type 1 and 2), who agreed to take varenicline and attend an intense smoking cessation program once a week given by multidisciplinary team. 41 (14 women, 27 men) diabetic smokers accepted to follow the program. The participants were very addicted (FTND 9/11, 30cigs/day), motivated (8,1/10) but lacking confidence (5,1/10). Characteristics shown on Fig 1a. After 3 months 25 participants quit smoking (61%), 7 reduced more than half the cigarettes smoked daily, while 9 participants quit the program. Interestingly, patients who quit the program showed higher levels of psychopathology compared to those who continued. Changes of body weight and rest metabolism rate (RMR) were not significant after smoking cessation (RMR measurements for DM 2 only, N=21) (Fig 1b). HDL was significantly increased. Findings were partly attributed to an increase of physical activity level reported after strong recommendations (Fig 1c). Diabetics succeeded in quitting (61%), ameliorated lipidemic profile, without a statistically significant PSWG by improving physical activity.