Smoking increases mortality risk among women with type 2 diabetes


NEW YORK (Reuters Health) – New data from the Nurses' Health Study indicate that women with type diabetes 2 who smoke cigarettes have a significantly greater mortality risk compared with nonsmokers, and the risk increases with the number of cigarettes smoked per day.

Dr. Wael K. Al-Delaimy from the Harvard School of Public Health, Boston, and colleagues collected data on 7401 women with type 2 diabetes, who participated in the Nurses' Health Study. During 20 years of follow-up, from 1976 to 1996, 724 of these women died, according to a report in the December issue of Diabetes Care.

Multivariate analysis, adjusting for age, hypertension, high cholesterol and other cardiovascular risk factors, showed that compared with women who had never smoked, women who smoked cigarettes had a significantly increased risk of death that was dose related.

For women who used to smoke, the relative risk of mortality was 1.31; for women who smoke 1 to 14 cigarettes per day is was 1.43; for women who smoke 15 to 34 cigarettes per day it was 1.64; and for women smoking 35 or more cigarettes per day the relative risk was 2.19 (p = 0.002 for trend), Dr. Al-Delaimy's team found.

Women who had stopped smoking for 10 years or more had only a slightly increased of mortality of compared with women who had never smoked, (relative risk 1.11). But for women who had stopped smoking recently the risk remained high, the investigators add

Dr. Al-Delaimy and colleagues conclude that "mortality rates among women with diabetes are strongly related to their smoking habits, with heavier smokers having a twofold higher risk than never smokers."

The authors point out that "the prevalence of smoking is still high among diabetic patients, although several studies have indicated that patients with diabetes are more motivated to quit smoking than healthy individuals. Therefore, greater efforts are needed to decrease smoking in this high-risk population."

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