smoking cessation

[daxsmith05]

Have given up smoking and HbA1c increased from 42.925 mmol/mol to 51.2 mmol/mol is that normal and does it really take 3 years before the figures drop to the level the were before. Nursing times says so but predicts only a rise of 3.0 mmol/mol.
Have put on some weight but not that much.
Any advice?
Also had pneumonia jab PCV Prevnar 13 today will that make a difference?

 

[trophywench]

I don't think there is any direct link between smoking and the HbA1c test. Certainly the first time I packed it in I put on weight, but that was because when I missed having the security dummy of a fag in my hand - I replaced it with a biscuit!

Can you reduce your carbohydrate intake a bit more, to try and reduce your HbA1c? Or, up your exercise now you've packed in the weed?

 

[daxsmith05]

there is a link but I didn't expect it to affect it so much
the weight doesn't help
The link between smoking and HbA1c is mentioned in nursing times and the lancet so its definitely true
Can reduce carbs but wasn't expecting such a jump so was a bit of a shock to go from 42 to 51 so quick as had only stopped smoking 18 days at the time of the test and was and am still on NRT so expected a small jump.
Can reduce carbs and have started already as only got figures today at 2am, did test on 4th Apriel (cerascreen £29) at same time as a bloodspot for another condition and did cholesterol test too dropped 4.4 to 3.9 total cholesterol - using my own device,

 

[rebrascora]

I agree with @trophywench that the link between increased HbA1c and stopping smoking is more likely to to with increased eating rather than the cessation of smoking being the direct cause. Having put weight on (either due to increased carb intake or change of metabolism) will also increase insulin resistance so that will be impacting your HbA1c too.
If you can get out and walk more that should really help both with the weight and the HbA1c as well as cutting carbs a bit more.

 

[Eddy Edson]

I think this is one of the main studies which get cited in this area: https://core.ac.uk/download/pdf/162669254.pdf

Findings

10,692 adult smokers with T2DM were included. 3,131 (29%) quit smoking and remained abstinent for at least one year. After adjustment for potential confounders, HbA1c increased by 2.3mmol/l (95% CI 1.91to 2.77, p<0.001) after quitting. HbA1c decreased as abstinence continued and became comparable to that of continual smokers after 3 years. This increase in HbA1c was not mediated by weight change.

Interpretation

In T2DM smoking cessation is associated with deterioration in glycaemic control, lasting 3 years, and unrelated to weight gain. At a population level, this temporary rise could increase microvascular complications.

So according to this, the HbA1c increase wasn't explained by weight gain, but see the "discussion" section for nuance around this & other potential confounders.

FWIW, on a tangent, I would really like to see lots of HbA1c studies recreated using average BG instead, now that GCM's are widely available and cheaper. Eg: smoking cessation can certainly affect red blood cells, in terms of numbers & morphology, and presumably that could have an impact on HbA1c measurement without there being an actual BG change.

There very often seems to be an assumption that HbA1c is a much more accurate and stable proxy for avg BG levels than it actually is, and I'm sure that this quite often distorts interpretations of studies. Avg BG levels measured directly via CGM would provide a much better basis.

 

[mikeyB]

When I gave up smoking my pipe I lost weight, mainly because the absence of nicotine caused a flare up of my ulcerative colitis. And that has happened twice, after restarting smoking and stopping again. I now vape, so I get the nicotine without all the tars and gubbins that cause health problems. Since vaping, my PEF and FeV have returned to near normal, as are my bowels - unless I don’t take enough Creon.

At none of the above circumstances did my HbA1c alter to any degree.

 

[daxsmith05]

cannot get out walking as can only walk 15 to 20 yds
Had to goto pharmacy in a wheelchair and is only about 15M from parking place
Went to Kamsons (for PCV Prevnar 13 Pneumonia jab today) 28 days smoke free as of 0919 today. Saturday will be a month so having a takeaway chinese. One won't make much difference

 

[daxsmith05]

My BP is fractionally below 120/80
Possibly due to a medication that lowers HbA1c by 3 points and affects BG BP HR and all sorts and has to be sugared as the sugar free has aspartame which I cannot have (I have PKU)
Hoping to reduce it soon too