Sebastian-Valles Fernando, Martinez-Alfonso Julia, Navas-Moreno Victor, Arranz-Martin Jose Alfonso, Tapia-Sanchiz Maria Sara, Raposo-López Juan José, Sampedro-Nuñez Miguel Antonio, Martínez-Vizcaino Vicente, Marazuela Mónica
Department of Endocrinology and Nutrition, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria de La Princesa, Universidad Autónoma de Madrid, Madrid, 28006 Spain.
Department of Family and Community Medicine, Hospital La Princesa/Centro de Salud Daroca, Madrid, 28006 Spain.
J Diabetes Metab Disord. 2024 Dec 16;24(1):11. doi: 10.1007/s40200-024-01535-y. eCollection 2025 Jun.
This study examined the influence of smoking on glycaemic control in individuals with type 1 diabetes (T1D) using flash continuous glucose monitoring (F-CGM) systems, as well as its potential mediating role in the relationship between socioeconomic status (SES) and glycaemic control.
This study included 378 subjects with T1D (18% smokers). Glucose metrics cloud downloads were obtained over a period of 14 days. Mean annual net income per person based on census tract data was used as a proxy for SES. Mediation analysis was performed using four-way effect decomposition procedures.
Smokers exhibited significantly lower net income than non-smokers ( < 0.001). Compared to smokers, non-smokers showed better glycaemic control characterized as higher time in range (TIR) 70-180 mg/dL ( = 0.002) and lower glycosylated haemoglobin levels ( = 0.008). Mediation analysis revealed a significant mediating role of smoking in the relationship between SES and glycaemic control (TIR).
Our data suggest that smoking exerts a detrimental effect on glycaemic control in individuals with T1D using F-CGM systems. In addition, tobacco use partially mediates the relationship between SES and glycaemic control. Thus, adopting smoking cessation measures could lead to improved glycaemic control and help mitigate the impact of social inequalities on T1D.
The online version contains supplementary material available at 10.1007/s40200-024-01535-y.
本研究使用闪光连续血糖监测（F-CGM）系统，探讨吸烟对1型糖尿病（T1D）患者血糖控制的影响，以及吸烟在社会经济地位（SES）与血糖控制关系中的潜在中介作用。
本研究纳入了378例T1D患者（18%为吸烟者）。在14天的时间内获取血糖指标云下载数据。基于普查区数据的人均年净收入用作SES的替代指标。使用四向效应分解程序进行中介分析。
吸烟者的净收入显著低于非吸烟者（<0.001）。与吸烟者相比，非吸烟者的血糖控制更好，表现为血糖在70-180mg/dL范围内的时间（TIR）更长（=0.002），糖化血红蛋白水平更低（=0.008）。中介分析显示，吸烟在SES与血糖控制（TIR）的关系中起显著中介作用。
我们的数据表明，使用F-CGM系统时，吸烟对T1D患者的血糖控制有不利影响。此外，吸烟部分介导了SES与血糖控制之间的关系。因此，采取戒烟措施可能会改善血糖控制，并有助于减轻社会不平等对T1D的影响。
在线版本包含可在10.1007/s40200-024-01535-y获取的补充材料。
