The effect of smoking on the risk of gestational diabetes mellitus and the OGTT profile during pregnancy

Published:October 26, 2019DOI:https://doi.org/10.1016/j.diabres.2019.107901

      Abstract

      Objective

      To analyze the relationship between smoking and the risk of GDM, as well as with the OGTT profile during pregnancy.

      Patients and methods

      A total of 7437 pregnant women were studied. OGTT was performed at the 3rd trimester. Women were categorized as non-smokers (A), as those who ceased smoking at pregnancy (B), and as smokers (C).

      Results

      5434 (73.1%) women were group A, 1191 (16%) group B and 812 (10.9%) group C. The rates of GDM among the groups were: A 33.7%, B 34.2%, C 34.2% (ns). However, the number of individuals requiring insulin treatment was significantly different: A 39.2%, B 47.5%, C 50.6% (p < 0.001). Regarding OGTT, fasting glucose levels were significantly higher in group C (89 ± 13 vs 86 ± 12 mg/dl) compared to A, whereas 3-h glucose values were significantly lower (104 ± 33 vs 112 ± 32 mg/dl) (p < 0.001). Group B demonstrated intermediate glucose concentrations. Similar findings were observed in women without GDM. In women with GDM, higher 1-h glucose levels were measured in group C (210 ± 31 vs 205 ± 28 mg/dl) compared with A (p = 0.024). Further, group C sub-analysis found that those who smoked more than 10 cigarettes showed significantly lower 3-h glucose levels (111 ± 31 vs 128 ± 40 mg/dl) compared to those who smoked less than 10 (p = 0.006). HbA1c in women with GDM was higher in group C (4.6 ± 0.6 vs 4.5 ± 0.6%) compared with A (p = 0.027).

      Conclusions

      The present study did not show any correlation between smoking and GDM risk. However, OGTT profile and HbA1c differed according to smoking status in women with and without GDM.

      Keywords

      Abbreviations:

      GDM (gestational diabetes mellitus), OGTT (oral glucose tolerance test)
      To read this article in full you will need to make a payment

      References

        • Will J.C.
        • Galuska D.A.
        • Ford E.S.
        • Mokdad A.
        • Calle E.E.
        Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study.
        Int J Epidemiol. 2001; 30: 540-546
        • Cho N.H.
        • Chan J.C.
        • Jang H.C.
        • Lim S.
        • Kim H.L.
        • Choi S.H.
        Cigarette smoking is an independent risk factor for type 2 diabetes: a four- year community-based prospective study.
        Clin Endocrinol (Oxf). 2009; 71: 679-685
        • Willi C.
        • Bodenmann P.
        • Ghali W.A.
        • Faris P.D.
        • Cornuz J.
        Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis.
        JAMA. 2007; 298: 2654-2664
        • Hofer S.E.
        • Rosenbauer J.
        • Grulich-Henn J.
        • Naeke A.
        • Fröhlich-Reiterer E.
        • Holl R.W.
        • et al.
        Smoking and metabolic control in adolescents with type 1 diabetes.
        J Pediatr. 2009; 154: 20-23
        • Soulimane S.
        • Simon D.
        • Herman W.H.
        • Lange C.
        • Lee C.M.
        • Colagiuri S.
        • et al.
        HbA1c, fasting and 2 h plasma glucose in current, ex- and never-smokers: a meta-analysis.
        Diabetologia. 2014; 57: 30-39
        • Terry P.D.
        • Weiderpass E.
        • Ostenson C.G.
        • Cnattingius S.
        Cigarette smoking and the risk of gestational and pregestational diabetes in two consecutive pregnancies.
        Diab Care. 2003; 26: 2994-2998
        • Wendland E.M.
        • Pinto M.E.
        • Duncan B.B.
        • Belizan J.M.
        • Schmidt M.I.
        Cigarette smoking and risk of gestational diabetes: a systematic review of observational studies.
        BMC Preg Childb. 2008; 8: 53
        • England L.J.
        • Levine R.J.
        • Qian C.
        • Soule L.M.
        • Schisterman E.F.
        • Yu K.F.
        • et al.
        Glucose tolerance and risk of gestational diabetes mellitus in nulliparous women who smoke during pregnancy.
        Am J Epidemiol. 2004; 160: 1205-1213
        • Moore Simas T.A.
        • Szegda K.L.
        • Liao X.
        • Pekow P.
        • Markenson G.
        • Chasan-Taber L.
        Cigarette smoking and gestational diabetes mellitus in Hispanic woman. Cigarette smoking and gestational diabetes mellitus in Hispanic woman.
        Diab Res Clin Pract. 2014; 105: 126-134
        • Hummel M.
        • Baumgarten A.
        • Hummel S.
        • König S.
        • Ziegler A.G.
        Smoking behavior during pregnancy of women with type 1 or gestational diabetes.
        Dtsch Med Wochenschr. 2007; 132: 1153-1158
        • Robertson H.
        • Pearson D.W.
        • Gold A.E.
        Severe hypoglycaemia during pregnancy in women with Type 1 diabetes is common and planning pregnancy does not decrease the risk.
        Diab Med. 2009; 26: 824-826
        • Aulinas A.
        • Colom C.
        • García Patterson A.
        • Ubeda J.
        • María M.A.
        • Orellana I.
        • et al.
        Smoking affects the oral glucose tolerance test profile and the relationship between glucose and HbA1c in gestational diabetes mellitus.
        Diab Med. 2016; 33: 1240-1244
        • American Diabetes Association
        Gestational diabetes mellitus.
        Diab Care. 2000; 23: S77-S79
        • Janzon L.
        • Berntorp K.
        • Hanson M.
        • Lindell S.E.
        • Trell E.
        Glucose tolerance and smoking: a population study of oral and intravenous glucose tolerance tests in middle-aged men.
        Diabetologia. 1983; 25: 86-88