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Insulin resistance in smokers undergoing smoking cessation

Institution: Friends Research Institute, Inc.
Investigator(s): Theodore Friedman, M.D., Ph.D.
Award Cycle: 2010 (Cycle 19) Grant #: 19CA-0195H Award: $684,186
Subject Area: Cardiovascular Disease
Award Type: California Research Award

Initial Award Abstract
Cigarette smoking increases risk for heart disease, but also abnormal blood sugar and insulin handling that can lead to diabetes. But exactly how smoking does these things has not been well studied. Strangely, smoking also leads to weight loss, while quitting leads to weight gain; just the reverse of what would be expected given the adverse effects of smoking on blood sugar handling. We propose a novel way to study how smoking does these things in humans by examining smokers before and after enrolling in an aggressive program to quit smoking, and then again after some of those quitters naturally resume smoking later on. This will tell us the effects of smoking, in both directions (quitting, as well as re-starting), on the body's handling of blood sugar and other associated features. We will use a sophisticated method that can simultaneously measure the body's blood sugar usage, the liver's response to insulin, and the body's ability to burn sugar and fats, as well as measure changes in fat and lean body tissues, distribution of fat across different regions of the body, and other markers related to the body's response to insulin. Smoking, and successful quitting, will be verified through breath and urine samples, and we will control for changes in diet and exercise habits that can affect weight and other related measurements. We expect that this study will give us new knowledge about the metabolic effects of both quitting and re-starting smoking. Our studies may lead to individualized treatments for cigarette smoking cessation and may also highlight the need for smokers to stop smoking if they do not want to get diabetes and heart disease.