title: Comparison of Diabetes Risk Following Smoking Cessation Treatment Using Varenicline Versus Bupropion Among Obese Smokers.
abstract: BACKGROUND
  Recent literature suggests an initial increased risk of diabetes following smoking cessation.
  
  
  OBJECTIVE
  To compare the risk of developing diabetes among obese smokers who tried to quit smoking using bupropion versus varenicline.
  
  
  METHODS
  A population-based retrospective cohort study was conducted using the General Electric (GE) electronic medical record database (2006-2011). The cohort consisted of obese adult smokers without a diabetes diagnosis at baseline and newly initiating use of either bupropion or varenicline. This cohort was then followed for 1 year to observe the risk of developing diabetes. The relative risk of bupropion versus varenicline on developing diabetes was assessed using Cox Proportional Hazards regression model after controlling for covariates.
  
  
  RESULTS
  The sample comprised of 78,002 obese smokers of which 1,937 (2.36%) developed diabetes during 1 year follow-up. Diabetes incidence rate was relatively comparable who used varenicline and bupropion (23.50 versus 25.80 per 1,000 person-years). Obese smokers who were prescribed bupropion had a statistically significant higher risk of developing diabetes during 1 year following cessation treatment than those who were prescribed varenicline. ([HR]: 1.58, 95% CI: 1.09-2.27) in the multivariate model.
  
  
  CONCLUSIONS
  Obese smokers who were prescribed bupropion might have a higher risk of developing diabetes during 1 year follow up compared to those who were prescribed varenicline. The clinical significance of the finding that bupropion had a higher risk of developing diabetes may need further investigation.
authors.affiliation: a Department of Pharmaceutical Health Outcomes and Policy , University of Houston , Houston , Texas , USA.
authors.forename: Mo
authors.initials: M
authors.lastname: Yang
authors.affiliation: a Department of Pharmaceutical Health Outcomes and Policy , University of Houston , Houston , Texas , USA.
authors.forename: Hua
authors.initials: H
authors.lastname: Chen
authors.affiliation: a Department of Pharmaceutical Health Outcomes and Policy , University of Houston , Houston , Texas , USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Johnson
authors.affiliation: a Department of Pharmaceutical Health Outcomes and Policy , University of Houston , Houston , Texas , USA.
authors.forename: Ekere James
authors.initials: EJ
authors.lastname: Essien
authors.affiliation: b School of Public Health , University of Texas Health Science Center at Houston , Houston , Texas , USA.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Peters
authors.affiliation: a Department of Pharmaceutical Health Outcomes and Policy , University of Houston , Houston , Texas , USA.
authors.forename: I-Hsuan
authors.initials: IH
authors.lastname: Wu
authors.affiliation: a Department of Pharmaceutical Health Outcomes and Policy , University of Houston , Houston , Texas , USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Abughosh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016642:Bupropion / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D009765:Obesity / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D012907:Smoking / Q000188:drug therapy* / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D000068580:Varenicline / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D018765:Dopamine Uptake Inhibitors; D018722:Nicotinic Agonists; D016642:Bupropion; D000068580:Varenicline
keywords: bupropion; comparative effectiveness; risk of diabetes; smoking cessation; varenicline