title: Smoking and metabolic control in adolescents with type 1 diabetes.
abstract: OBJECTIVE
  To relate self-reported smoking frequency to metabolic control and other cardiovascular risk factors in adolescents with type 1 diabetes.
  
  
  METHODS
  In the multicenter Diabetes Patienten Verlaufsdokumentationssystem database from Germany and Austria, anonymized records on 27 561 patients < 20 years of age with documented smoking status were available for analysis.
  
  
  RESULTS
  Self-reported smoking was negligible in patients younger than 11 years (0.1%), increasing to 5% in 11- to 15-year-old patients, and 28.4% in the 15- to 20-year-old age group. Multivariate analysis with adjustment for age, diabetes duration, sex, insulin therapy, and center differences, revealed that smokers had higher HbA1c-levels compared with non-smokers (9.1% vs 8.0%, P < .0001). Diastolic blood pressure was higher (68.2 vs 67.6 mm Hg, P < .0001), and the lipid profile was unfavorable in patients who smoke: Triglycerides and total cholesterol were higher and high-density lipoprotein-cholesterol was lower (all P < .0001).
  
  
  CONCLUSIONS
  Smokers display significantly worse metabolic control and a higher cardiovascular risk profile. Although not attested in trials, we state that education about smoking, smoking prevention, and psychological help for smoking cessation should be an integral part of comprehensive pediatric care for adolescent patients with type 1 diabetes.
authors.affiliation: Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria. Sabine.E.Hofer@i-med.ac.at
authors.forename: Sabine E
authors.initials: SE
authors.lastname: Hofer
authors.forename: Joachim
authors.initials: J
authors.lastname: Rosenbauer
authors.forename: Juergen
authors.initials: J
authors.lastname: Grulich-Henn
authors.forename: Andrea
authors.initials: A
authors.lastname: Naeke
authors.forename: Elke
authors.initials: E
authors.lastname: Fröhlich-Reiterer
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D001317:Austria / Q000453:epidemiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000097:blood / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin