title: Higher risk of microvascular complications in smokers with type 1 diabetes despite intensive insulin therapy.
abstract: OBJECTIVE
  The aim of the study was to evaluate the relationship between smoking status and the incidence of microvascular complications in patients with type 1 diabetes (DM1), treated with intensive functional insulin therapy (IFIT) from the onset of the disease.
  
  
  METHODS
  81 participants (51 men, 30 women) of Poznan Prospective Study (PoProStu) with mean age of 34.0 ± 6.4 years were included in this analysis. Patients were observed for 10.0 ± 1.5 years. Evaluation of microvascular complications of diabetes, such as retinopathy, diabetic kidney disease and neuropathy was performed. Patients were divided into two groups depending on the smoking status: smokers and non-smokers.
  
  
  RESULTS
  In the group of smokers (n=36) in comparison with patients who had never smoked (n=45) any microangiopathy (58.3% vs 33.3%, p=0.02), retinopathy (44.4% vs 20%, p=0.02), diabetic kidney disease (47.2% vs 24.4%, p=0.03) and neuropathy (25% vs 4.4%, p=0.02) were found more often. A significant relationship, adjusted for age, sex, duration of diabetes, presence of hypertension and HbA1c between smoking and neuropathy and retinopathy was revealed [OR 10.16 (95%CI 1.59-64.95); p=0.01 and OR 3.50 (95%CI 1.01-12.12); p=0.04, respectively].
  
  
  CONCLUSIONS
  The results show that in patients with DM1, there is a strong relationship between smoking and the diabetic microvascular complications, especially with neuropathy, despite treatment from the initial diagnosis with intensive insulin therapy.
authors.affiliation: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza 2, 60-834 Poznan, Poland. Electronic address: aleksandrauruska@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Uruska
authors.affiliation: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza 2, 60-834 Poznan, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Araszkiewicz
authors.affiliation: Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Dluga 1/2, 61-848 Poznan, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Uruski
authors.affiliation: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Raszeja Hospital, Mickiewicza 2, 60-834 Poznan, Poland.
authors.forename: D
authors.initials: D
authors.lastname: Zozulinska-Ziolkiewicz
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000097:blood / Q000209:etiology*; D003928:Diabetic Nephropathies / Q000097:blood / Q000209:etiology; D003929:Diabetic Neuropathies / Q000097:blood / Q000209:etiology; D003930:Diabetic Retinopathy / Q000097:blood / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D011044:Poland; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human