The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the...The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the harmful effects of elevated blood glucose levels,accelerating the vascular damage seen in patients with diabetes.Smoking cessation has clear benefits in terms of reducing cardiovascular morbidity and mortality.However,there is less evidence for the impact of smoking cessation on other diabetes-related complications.Studies in people with diabetes have shown improvement as well as temporary deterioration in glycemic control after ceasing smoking.Only a few studies have described the effect of quitting smoking on insulin resistance and lipid parameters,however,their results have been inconclusive.In this situation,healthcare professionals should not assume that cessation of smoking will improve metabolic parameters in patients with diabetes.It seems they should, first of all, emphasize the prevention of weight gain that may be associatedwith quitting smoking. The lack of data regarding the metabolic effects of smoking and smokingcessation in diabetes is very disappointing and this area needs to be addressed.展开更多
Smoking increases complications and mortality in people with diabetes.Quitting delivers major benefits,but physiological(weight gain,insulin sensitivity shifts)and psychological barriers make cessation harder in this ...Smoking increases complications and mortality in people with diabetes.Quitting delivers major benefits,but physiological(weight gain,insulin sensitivity shifts)and psychological barriers make cessation harder in this group.Our review article examined strategies tailored to people with diabetes.All smokers with diabetes should receive clear,personalized advice to quit,embedded in routine care.Among the available medications,varenicline has the strongest evidence in this population.Nicotine replacement therapy and bupropion may help but have limited diabetes-specific data,so they should be used with caution.Tobacco harm reduction(e-cigarettes,heated tobacco products)may facilitate switching away from combustible cigarettes and reduce exposure,although the long-term safety and efficacy in diabetes remain uncertain.Glucagon-like peptide-1 receptor agonists can aid weight and glycemic control and may indirectly support cessation.Digital tools(apps,wearables,and remote monitoring)offer real-time support and adherence tracking,although diabetes-specific effectiveness is still being established.Smoking cessation in people with diabetes requires urgent attention.Evidence-based interventions should be integrated into routine care,with particular attention given to early monitoring of glucose,body weight,and blood pressure after quitting,plus structured follow-up.More research should develop and test tailored,longterm strategies for this high-risk group,including pragmatic trials integrating harm reduction and digital support.展开更多
In 2020,international consensus guidelines recommended renaming a non-alcoholic fatty liver disease(NAFLD)to metabolic-associated fatty liver disease(MAFLD)(1).However,these two terms are not interchangeable.Diagnosis...In 2020,international consensus guidelines recommended renaming a non-alcoholic fatty liver disease(NAFLD)to metabolic-associated fatty liver disease(MAFLD)(1).However,these two terms are not interchangeable.Diagnosis of MAFLD is established while hepatic steatosis(diagnosed by the use of non-invasive methods as well as liver biopsy)is accompanied by overweight/obesity or type 2 diabetes(T2D)or two or more metabolic risk factors,including increased waist circumference(with cut off values specific for the population),arterial hypertension,hypertriglyceridemia,low high-density lipoprotein cholesterol(HDL-C)(<40 mmol/L in women and<50 mmol/L in men),prediabetes(impaired fasting glucose,impaired glucose tolerance or glycated hemoglobin 5.7-6.4%).展开更多
基金Department of Clinical and Experimental Medicine of the University of Catania,No.6C813202024/1_3_02_07_01/2020。
文摘The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the harmful effects of elevated blood glucose levels,accelerating the vascular damage seen in patients with diabetes.Smoking cessation has clear benefits in terms of reducing cardiovascular morbidity and mortality.However,there is less evidence for the impact of smoking cessation on other diabetes-related complications.Studies in people with diabetes have shown improvement as well as temporary deterioration in glycemic control after ceasing smoking.Only a few studies have described the effect of quitting smoking on insulin resistance and lipid parameters,however,their results have been inconclusive.In this situation,healthcare professionals should not assume that cessation of smoking will improve metabolic parameters in patients with diabetes.It seems they should, first of all, emphasize the prevention of weight gain that may be associatedwith quitting smoking. The lack of data regarding the metabolic effects of smoking and smokingcessation in diabetes is very disappointing and this area needs to be addressed.
文摘Smoking increases complications and mortality in people with diabetes.Quitting delivers major benefits,but physiological(weight gain,insulin sensitivity shifts)and psychological barriers make cessation harder in this group.Our review article examined strategies tailored to people with diabetes.All smokers with diabetes should receive clear,personalized advice to quit,embedded in routine care.Among the available medications,varenicline has the strongest evidence in this population.Nicotine replacement therapy and bupropion may help but have limited diabetes-specific data,so they should be used with caution.Tobacco harm reduction(e-cigarettes,heated tobacco products)may facilitate switching away from combustible cigarettes and reduce exposure,although the long-term safety and efficacy in diabetes remain uncertain.Glucagon-like peptide-1 receptor agonists can aid weight and glycemic control and may indirectly support cessation.Digital tools(apps,wearables,and remote monitoring)offer real-time support and adherence tracking,although diabetes-specific effectiveness is still being established.Smoking cessation in people with diabetes requires urgent attention.Evidence-based interventions should be integrated into routine care,with particular attention given to early monitoring of glucose,body weight,and blood pressure after quitting,plus structured follow-up.More research should develop and test tailored,longterm strategies for this high-risk group,including pragmatic trials integrating harm reduction and digital support.
文摘In 2020,international consensus guidelines recommended renaming a non-alcoholic fatty liver disease(NAFLD)to metabolic-associated fatty liver disease(MAFLD)(1).However,these two terms are not interchangeable.Diagnosis of MAFLD is established while hepatic steatosis(diagnosed by the use of non-invasive methods as well as liver biopsy)is accompanied by overweight/obesity or type 2 diabetes(T2D)or two or more metabolic risk factors,including increased waist circumference(with cut off values specific for the population),arterial hypertension,hypertriglyceridemia,low high-density lipoprotein cholesterol(HDL-C)(<40 mmol/L in women and<50 mmol/L in men),prediabetes(impaired fasting glucose,impaired glucose tolerance or glycated hemoglobin 5.7-6.4%).
