Smoking and diabetes

Smoking can be a big problem for diabetic people as it causes many problems.  There is growing  evidence to suggest that smoking is an independent risk factor for diabetes and that among people with diabetes, and that smoking causes  the risk of serious diseases and even premature death. 

People with diabetes already have an increased risk of heart disease, which is made worse if they smoke.  Diabetes acts in several ways to damage the heart: high glucose levels affect the walls of the arteries making them more likely to develop fatty deposits which in turn makes it more difficult for the blood to circulate. People with diabetes are more likely to have high blood pressure and high levels of fats such as triglycerides. 

Insulin Resistance

Smoking has also been identified as a risk factor for insulin resistance which can lead to diabetes.  People with insulin resistance cannot properly use insulin and  may initially have higher than normal amounts of insulin circulating in their blood, which is known as hyperinsulinemia. 

Several factors, including genetics and obesity, increase a person’s risk of insulin resistance and smoking has also been shown to increase the risk of this condition.  A study of 40 patients with Type 2 diabetes found insulin resistance was markedly aggravated among those who smoked.  

The effect of smoking on complications of diabetes

Smoking is associated with lots of complications of diabetes.  Nephropathy (kidney disease) has been shown to be common in Type 1 diabetic patients who smoke  and smoking increases the risk of albuminuria in both types of diabetes. (Albuminuria means the presence of protein  in the urine and can indicate signs of kidney disease.) 

The relationship between cigarette smoking and retinothapy (disorders of the retina) is less well defined than that of other microvascular complications of diabetes. However, some studies have found an association between smoking and diabetic retinopathy.

There is overwhelming evidence that stopping smoking reduces the risk of cardiovascular disease, lung disease, cancer and stroke.  As diabetes increases the risk for heart disease and stroke, it means that stopping smoking will reduce the risk of complications from diabetes such as heart disease.   It is suggested that smokers with diabetes may be less successful in quitting than smokers without diabetes and that intensive strategies should be considered to optimise successful cessation. One possible explanation for the lower quitting rates among people with diabetes is the fact that stopping smoking is associated with weight gain and this is likely to be of concern in people who have diabetes and are already overweight. 

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