Incorporating Post-Cessation Weight-Control Coaching into Smoking Cessation Therapy to Reduce Type 2 Diabetes Risk
Journal
Nutrients
Journal Volume
13
Journal Issue
10
Date Issued
2021-10-25
Author(s)
Abstract
Post-cessation weight gain (PCWG) facilitates short-term type 2 diabetes (T2D) risk in prediabetic smokers in the absence of complementary measures. In this shared decision-making-based non-randomized controlled trial, prediabetic smokers joined the Fight Tobacco and Stay Fit (FIT2) program or received usual care. The 16-week FIT2 program combined smoking cessation therapy with individualized coaching in diet and physical activity strategies for PCWG restriction (NCT01926041 at ClinicalTrials.gov). During a mean follow-up period of 1316 days, 217 participants (36.8%) developed T2D, and 68 (11.5%) regressed to normoglycemia. In the intention-to-treat analysis (n = 589), the FIT2 program was associated with a reduced T2D risk (HR, 0.58; 95% CI, 0.40-0.84) and a higher probability of regression to normoglycemia (HR, 1.91; 95% CI, 1.04-3.53) compared with usual care. The post-program quitters were at lower T2D risk (HR, 0.63; 95% CI, 0.44-0.92) and were more likely to regress to normoglycemia (HR, 1.83; 95% CI, 1.01-3.30) compared with the controls in the time-varying analysis (n = 532). We demonstrated that the FIT2 program was negatively associated with long-term T2D risk and positively associated with the probability of regression to normoglycemia compared with usual care. To prevent T2D development, we recommend simultaneously promoting smoking abstinence and lifestyle coaching for PCWG restriction.
Subjects
obesity; prediabetes; primary care; smoking cessation; type 2 diabetes mellitus
Obesity; Prediabetes; Primary care; Smoking cessation; Type 2 diabetes mellitus
SDGs
Other Subjects
glucose; varenicline; glycosylated hemoglobin; adult; aged; Article; body weight control; drug dose increase; female; follow up; glucose blood level; human; intention to treat analysis; major clinical study; male; non insulin dependent diabetes mellitus; risk assessment; risk reduction; shared decision making; smoking; smoking cessation; body weight gain; Kaplan Meier method; mentoring; middle aged; non insulin dependent diabetes mellitus; risk factor; time factor; Adult; Aged; Diabetes Mellitus, Type 2; Glycated Hemoglobin A; Humans; Intention to Treat Analysis; Kaplan-Meier Estimate; Mentoring; Middle Aged; Risk Factors; Smoking Cessation; Time Factors; Weight Gain
Type
journal article