Association between smoking and glycated hemoglobin in type II diabetes mellitus male patients visiting outpatient department: A hospital-based study

Abstract

Background: Smoking is emerging as a public health concern in India, with 30% of the population (majority males) consuming tobacco products. The risk of metabolic syndrome is 1.07–1.66 times higher in smokers. Both smoking and diabetes are expected to rise in India. Aims and Objectives: The association of smoking with glycated hemoglobin (HBA1C) was analyzed in the present study. The effect of tobacco on total leucocyte count (TLC) and HBA1C was also studied. Materials and Methods: The study included 150 male diabetics grouped into smoker and non-smoker categories. Currents were further categorized as per smoking intensity. TLC and HBA1C were evaluated, and the data were analyzed using appropriate statistical tests in SPSS 21.0 and Microsoft Excel. A P < 0.05 was taken as significant. Results: HBA1C increased significantly (P < 0.0101) with an increase in intensity of smoking, but the difference was insignificant between non-smokers and mild (P = 0.125) to moderate (P = 0.07) intensity smokers. TLC increased significantly with an increase in smoking intensity compared to non-smokers (P < 0.001). Differences in TLC were insignificant between mild smokers and non-smokers (P = 0.114). HBA1C and TLC were significantly (P < 0.001) raised in current smokers as compared to ex-smokers and non-smokers, but the difference between HBA1C in non-smokers and ex-smokers was insignificant (P = 0.534). TLC increased insignificantly in ex-smokers as compared to non-smokers (P = 0.129). Regression analysis showed that HBA1C was significantly higher in ex-smokers (β = 0.0438, P = 0.021) and current smokers (β = 0.682, P = 0.001) than non-smokers. With the increase in the severity of smoking, HBA1C was higher than in non-smokers, but the association was insignificant. A non-significant positive association was found between TLC and HBA1C in current smokers (r = 0.049, P = 0.781) and ex-smokers (r = 0.036, P = 0.824), and a non-significant (P = 0.745) negative association (r= −0.070) was found between two non-smokers. Conclusion: In smokers, HBA1C and TLC are higher and are further raised with increased smoking intensity.