OAR@UM Community:

Addressing the dual challenge : managing smoking cessation in patients with diabetes

2025-12-19T13:11:04Z

Title: Addressing the dual challenge : managing smoking cessation in patients with diabetes Authors: Russo, Cristina; Walicka, Magdalena; Cohen, Gal; Bellanca, Carlo Maria; Geraci, Giulio; Caponnetto, Pasquale; Noviello, Dario Elvio; Chianetta, Roberta; George, Jacob; Sammut, Roberta; Franek, Eward; Polosa, Riccardo Abstract: 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, long-term strategies for this high-risk group, including pragmatic trials integrating harm reduction and digital support.

Pharmacological interventions for smoking cessation in type 2 diabetes : a systematic review with meta-analysis and GRADE evaluation

2025-12-19T12:58:22Z

Title: Pharmacological interventions for smoking cessation in type 2 diabetes : a systematic review with meta-analysis and GRADE evaluation Authors: Martin, Alison; La Rosa, Giusy Rita Maria; Rice, Hannah; Bertuzzi, Andrea; Witkowski, Michal; Anastasi, Erika; Geraci, Giulio; Polosa, Riccardo; Campagna, Davide; Di Ciaula, Agostino; Dugal, Tabinda; Kengne, Andre Pascal; Misra, Anoop; Raza, Syed Abbas; Russo, Cristina; Sammut, Roberta; Somasundaram, Noel; Mustafa, Norlaila; Le Dinh, Phuong; Ibragimova, Nilufar; Walicka, Magdalena Abstract: Aims: To evaluate the efficacy and safety of pharmacological therapies for smoking cessation in individuals with Type 2 Diabetes Mellitus (T2DM) through a systematic review, meta-analysis, and GRADE evaluation.; Methods: PubMed and Scopus were searched on 7 June 2024 using relevant keywords. Randomized controlled trials and prospective cohort studies involving adult smokers with T2DM receiving pharmacological treatments for smoking cessation were included. Data were extracted independently by two reviewers. Random-effects meta-analyses were conducted, and the certainty of evidence was assessed using GRADE.; Results: Eighteen studies (19 publications) were included. Pharmacotherapy significantly increased continuous abstinence rates at 12 and 24 weeks (p < 0.001), with ORs of 4.17 (95 % CI: 2.71–6.42) and 3.80 (95 % CI: 2.52–5.72), respectively. At 52 weeks, varenicline was more effective than placebo (OR: 2.84, 95 % CI: 1.41–5.69, p = 0.003). Adverse events were more frequent with varenicline, but not significantly (OR: 1.40, 95 % CI: 0.98–1.98, p = 0.06).; Conclusions: Varenicline appears effective for smoking cessation in T2DM, with an acceptable tolerability profile. Bupropion and NRT show potential efficacy. However, most evidence comes from post hoc analyses in which diabetes was not a predefined variable, warranting cautious interpretation. Description: The supplementary data are attached.

Comment on Elsayed et al. 5. Facilitating positive health behaviors and well-being to improve health outcomes: standards of care in diabetes—2023. Diabetes Care 2023;46(Suppl. 1) : S68–S96

2025-12-19T10:00:38Z

Title: Comment on Elsayed et al. 5. Facilitating positive health behaviors and well-being to improve health outcomes: standards of care in diabetes—2023. Diabetes Care 2023;46(Suppl. 1) : S68–S96 Authors: Campagna, Davide; Di Ciuala, Agostino; Dugal, Tabinda; Kengne, Andre; Misra, Anoop; Polosa, Riccardo; Raza, Syed Abbas; Russo, Cristina; Sammut, Roberta; Somasundaram, Noel; Walicka, Magda Abstract: We wish to congratulate the Professional Practice Committee of the American Diabetes Association (ADA) for their recent update of the ADA Standards of Care in Diabetes. In particular, it is reassuring to see that the ADA is expanding its mission “to improve the lives of all people affected by diabetes” by addressing the problem of continued smoking. Smoking/tobacco cessation in diabetes is largely neglected, and it is important to bolster confidence in diabetes education programs across the world to help health professionals maximize the chances of their patients stopping smoking or using tobacco. [excerpt]

A web-based scoping review assessing the influence of smoking and smoking cessation on antidiabetic drug metabolism : implications for medication efficacy

2025-12-19T09:54:46Z

Title: A web-based scoping review assessing the influence of smoking and smoking cessation on antidiabetic drug metabolism : implications for medication efficacy Authors: Bellanca, Carlo Maria; Augello, Egle; Di Benedetto, Giulia; Burgaletto, Chiara; Cantone, Anna Flavia; Cantarella, Giuseppina; Bernardini, Renato; Polosa, Riccardo; Di Ciaula, Agostino; Dugal, Tabinda; Truro, Treliske; Kengne, Andre; Le Dinh, Phuong; Raza, Syed Abbas; Sammut, Roberta; Somasundaram, Noel; Walicka, Magda Abstract: Currently 1.3 billion individuals globally engage in smoking, leading to significant morbidity and mortality, particularly among diabetic patients. There is urgent need for a better understanding of how smoking influences antidiabetic treatment efficacy. The review underscores the role of cigarette smoke, particularly polycyclic aromatic hydrocarbons (PAHs), in modulating the metabolic pathways of antidiabetic drugs, primarily through the induction of cytochrome P450 (CYP450) enzymes and uridine diphosphate (UDP)-glucuronosyltransferases (UGTs), thus impacting drug pharmacokinetics and therapeutic outcomes. Furthermore, the review addresses the relatively uncharted territory of how smoking cessation influences diabetes treatment, noting that cessation can lead to significant changes in drug metabolism, necessitating dosage adjustments. Special attention is given to the interaction between smoking cessation aids and antidiabetic medications, a critical area for patient safety and effective diabetes management. This scoping review aims to provide healthcare professionals with the knowledge to better support diabetic patients who smoke or are attempting to quit, ensuring tailored and effective treatment strategies. It also identifies gaps in current research, advocating for more studies to fill these voids, thereby enhancing patient care and treatment outcomes for this at-risk population.