Is there an excess or lower diabetes risk in female cigarette smokers?
• Altan Onat, MD, FESC Emeritus from Cerrahpasa Medical Faculty, Istanbul University, Turkey Authors examining prospectively the association of smoking status with the development of incident type-2 diabetes in the ARIC cohort (1) arrived at the conclusion that smoking predicts incident diabetes, and smoking cessation leads to higher short-term risk. The first part of the conclusion was not convincing for several reasons: Firstly, because excess risk did not emerge in one-third (mild smokers) of the smokers. Secondly, the study does not clarify whether this risk is valid only for men or for both sexes, since sex-stratified analyses are totally missing. In the regression analyses, the referent never smokers and the top tertile were composed predominantly of different sexes differing substantially in risk. Sex adjustment may not disclose the situation for women who may well have been unaffected by the habit, though adjusted combined analyses have yielded excess risk. Thirdly, adjustment
