INTRODUCTION

Smoking is a modifiable risk factor for diabetes mellitus, but the association between changes in smoking behavior and new-onset diabetes mellitus (NODM) in dyslipidemic patients remains unclear. This study aimed to examine how changes in smoking habits affect NODM risk among individuals with dyslipidemia.

METHODS

This retrospective cohort study used data from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC). A total of 34282 patients diagnosed with dyslipidemia between 2012 and 2014 were followed until December 2019 (median follow-up: 5 years). Smoking behavior change was defined by transitions in smoking status and intensity across two health examinations. NODM was identified by fasting plasma glucose ≥126 mg/dL or ICD-10 codes E11-E14 with antidiabetic medication.

RESULTS

During follow-up, 2479 participants (7.23%) developed NODM. Those with NODM had higher prevalence of obesity, abdominal obesity, hypertension, abnormal liver function, and family history of diabetes. Current smokers had increased NODM risk (hazard ratio, HR=1.36; 95% CI: 1.22-1.50) versus non-smokers. Heavy smokers had higher risk (HR=1.43; 95% CI: 1.24-1.60) than moderate smokers (HR=1.35; 95% CI: 1.16-1.60). Compared to continuous smokers, quitters had reduced risk (HR=0.79; 95% CI: 0.64-0.98), while reducers showed no significant risk reduction (HR=0.82; 95% CI: 0.63-1.08).

CONCLUSIONS

Among patients with dyslipidemia, smoking cessation was associated with a lower risk of NODM compared to continued smoking. These results suggest potential benefits of quitting smoking in reducing diabetes risk in this population.