Association between smoking, insulin resistance and β-cell function in a North-western First Nation

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Abstract

Aims: Aboriginal peoples have a high prevalence of smoking and are at major risk for diabetes. The role of insulin resistance vs. compromised β-cell function in the link between smoking and glycaemic disease is not clear. This study tested whether relations between insulin resistance and β-cell function differ between current smokers, former smokers and non-smokers, and if having diabetes modifies smoking-related effects. Methods: A community-based diabetes screening initiative was mounted for a North-western First Nation (Interior Salishan) in rural British Columbia, Canada. Respondents were on-reserve Aboriginal people (n = 156), all adults 18 + years. Glycaemic status was determined by oral glucose tolerance test. Fasting values for glucose and insulin were used to estimate β-cell function and insulin resistance by homeostasis model assessment (HOMA). Analyses adjusted for age, sex, alcohol intake, education, body mass index and physical activity. Results: For normoglycaemic persons (n = 119) current smokers relative to non-smokers had high β-cell values [difference (95% confidence interval) 19.5 (17.1, 21.9)], while former smokers had low β-cell values [difference -22.8 (-20.3, -25.3)] (P < 0.0001). For diabetic persons (n = 37) differences were of equivalent direction but greater magnitude (P < 0.0001). Insulin resistance was for normoglycaemic persons highest for current smokers, and for diabetic persons lowest for current smokers (P = 0.021). Conclusions: Former smoking is associated with low β-cell function, and current smoking with high β-cell function, independent of diabetes in the Northwestern First Nation surveyed. Associations between smoking and insulin resistance vary according to glycaemic status. Smoking may have diametric acute and post-cessation effects on β-cell function and insulin resistance.

Original languageEnglish
Pages (from-to)188-193
Number of pages6
JournalDiabetic Medicine
Volume21
Issue number2
DOIs
Publication statusPublished - Feb 2004
Externally publishedYes

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Insulin Resistance
Smoking
British Columbia
Glucose Tolerance Test
Canada
Fasting
Body Mass Index
Homeostasis
Alcohols
Confidence Intervals
Insulin
Education
Glucose

Cite this

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title = "Association between smoking, insulin resistance and β-cell function in a North-western First Nation",
abstract = "Aims: Aboriginal peoples have a high prevalence of smoking and are at major risk for diabetes. The role of insulin resistance vs. compromised β-cell function in the link between smoking and glycaemic disease is not clear. This study tested whether relations between insulin resistance and β-cell function differ between current smokers, former smokers and non-smokers, and if having diabetes modifies smoking-related effects. Methods: A community-based diabetes screening initiative was mounted for a North-western First Nation (Interior Salishan) in rural British Columbia, Canada. Respondents were on-reserve Aboriginal people (n = 156), all adults 18 + years. Glycaemic status was determined by oral glucose tolerance test. Fasting values for glucose and insulin were used to estimate β-cell function and insulin resistance by homeostasis model assessment (HOMA). Analyses adjusted for age, sex, alcohol intake, education, body mass index and physical activity. Results: For normoglycaemic persons (n = 119) current smokers relative to non-smokers had high β-cell values [difference (95{\%} confidence interval) 19.5 (17.1, 21.9)], while former smokers had low β-cell values [difference -22.8 (-20.3, -25.3)] (P < 0.0001). For diabetic persons (n = 37) differences were of equivalent direction but greater magnitude (P < 0.0001). Insulin resistance was for normoglycaemic persons highest for current smokers, and for diabetic persons lowest for current smokers (P = 0.021). Conclusions: Former smoking is associated with low β-cell function, and current smoking with high β-cell function, independent of diabetes in the Northwestern First Nation surveyed. Associations between smoking and insulin resistance vary according to glycaemic status. Smoking may have diametric acute and post-cessation effects on β-cell function and insulin resistance.",
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Association between smoking, insulin resistance and β-cell function in a North-western First Nation. / Daniel, M.; Cargo, M. D.

In: Diabetic Medicine, Vol. 21, No. 2, 02.2004, p. 188-193.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between smoking, insulin resistance and β-cell function in a North-western First Nation

AU - Daniel, M.

AU - Cargo, M. D.

PY - 2004/2

Y1 - 2004/2

N2 - Aims: Aboriginal peoples have a high prevalence of smoking and are at major risk for diabetes. The role of insulin resistance vs. compromised β-cell function in the link between smoking and glycaemic disease is not clear. This study tested whether relations between insulin resistance and β-cell function differ between current smokers, former smokers and non-smokers, and if having diabetes modifies smoking-related effects. Methods: A community-based diabetes screening initiative was mounted for a North-western First Nation (Interior Salishan) in rural British Columbia, Canada. Respondents were on-reserve Aboriginal people (n = 156), all adults 18 + years. Glycaemic status was determined by oral glucose tolerance test. Fasting values for glucose and insulin were used to estimate β-cell function and insulin resistance by homeostasis model assessment (HOMA). Analyses adjusted for age, sex, alcohol intake, education, body mass index and physical activity. Results: For normoglycaemic persons (n = 119) current smokers relative to non-smokers had high β-cell values [difference (95% confidence interval) 19.5 (17.1, 21.9)], while former smokers had low β-cell values [difference -22.8 (-20.3, -25.3)] (P < 0.0001). For diabetic persons (n = 37) differences were of equivalent direction but greater magnitude (P < 0.0001). Insulin resistance was for normoglycaemic persons highest for current smokers, and for diabetic persons lowest for current smokers (P = 0.021). Conclusions: Former smoking is associated with low β-cell function, and current smoking with high β-cell function, independent of diabetes in the Northwestern First Nation surveyed. Associations between smoking and insulin resistance vary according to glycaemic status. Smoking may have diametric acute and post-cessation effects on β-cell function and insulin resistance.

AB - Aims: Aboriginal peoples have a high prevalence of smoking and are at major risk for diabetes. The role of insulin resistance vs. compromised β-cell function in the link between smoking and glycaemic disease is not clear. This study tested whether relations between insulin resistance and β-cell function differ between current smokers, former smokers and non-smokers, and if having diabetes modifies smoking-related effects. Methods: A community-based diabetes screening initiative was mounted for a North-western First Nation (Interior Salishan) in rural British Columbia, Canada. Respondents were on-reserve Aboriginal people (n = 156), all adults 18 + years. Glycaemic status was determined by oral glucose tolerance test. Fasting values for glucose and insulin were used to estimate β-cell function and insulin resistance by homeostasis model assessment (HOMA). Analyses adjusted for age, sex, alcohol intake, education, body mass index and physical activity. Results: For normoglycaemic persons (n = 119) current smokers relative to non-smokers had high β-cell values [difference (95% confidence interval) 19.5 (17.1, 21.9)], while former smokers had low β-cell values [difference -22.8 (-20.3, -25.3)] (P < 0.0001). For diabetic persons (n = 37) differences were of equivalent direction but greater magnitude (P < 0.0001). Insulin resistance was for normoglycaemic persons highest for current smokers, and for diabetic persons lowest for current smokers (P = 0.021). Conclusions: Former smoking is associated with low β-cell function, and current smoking with high β-cell function, independent of diabetes in the Northwestern First Nation surveyed. Associations between smoking and insulin resistance vary according to glycaemic status. Smoking may have diametric acute and post-cessation effects on β-cell function and insulin resistance.

KW - β-cell function

KW - Aboriginal health

KW - Cigarette smoking

KW - Insulin resistance

KW - Type 2 diabetes

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U2 - 10.1046/j.1464-5491.2003.01064.x

DO - 10.1046/j.1464-5491.2003.01064.x

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SP - 188

EP - 193

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

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