Issue 151 Item 2 Fasting BG Levels Linked With Smoking

Diabetic patients demonstrate and interaction between level of fasting glycemia, lung function and any past or present tobacco smoking. This is the finding of Dr I E Walter and colleagues at the Pulmonary Center, Boston University School of Medicine, Massachusetts, United States, from a study among 3,254 members of the Framingham Offspring Cohort in the Framingham Heart Study.

The clinicians point out that there has been an inconsistent association in patients between diabetes mellitus and a reduced level of pulmonary function. They decided to analyse the relationship of diabetes and of fasting blood glucose to the level of pulmonary function, and which was assessed by spirometry among the Offspring Cohort.

Diabetes was defined among patients as either a fasting blood glucose of 126 mg/dL or more, or whether they were receiving pharmacologic treatment for their condition. The patients were asked about their smoking behavior and were classified as current, former, or never smokers.

Predicted pulmonary function was determined by the researchers from the coefficients of a regression of pulmonary function on age, sex, and body habits among the 1,110 patients who had never smoked.

They found that both the diagnosis of diabetes. and a higher level of fasting blood glucose, were associated with lower than predicted levels of pulmonary function. The adverse effect of diabetes and glycemic level on pulmonary function was stronger among patients who had ever smoked in their lives compared with those who had never smoked.

These findings suggested to the clinicians an interaction between the level of fasting glycemia and tobacco smoking. Am J Respir Crit Care Med 2003;15:167.

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FACT: According to the Centers for Disease Control and Prevention, 8.9 percent of Wisconsin preschoolers were considered overweight in 1994 by state nutrition standards. By 1998, the percentage had popped to 10.1 percent; by 2000, to 11.4 percent.