Smoking may be a risk factor for diabetes   (December 13, 2007)

We're all familiar (I hope!) with the problems that cigarette smoking can cause for people with diabetes (PWD). Among others that have been described:

* People with diabetes are three times as likely to die of cardiovascular diseases. Smoking and diabetes together make you 11 times more likely to die of a heart attack or stroke.
* Smoking raises your blood sugar levels AND cuts your body's ability to use insulin, making it hard to control your diabetes. Smoking ONE cigarette reduces the body's ability to use insulin by 15%.
* Smoking increases your cholesterol levels and the levels of other fats in your blood. This increases your risk of having a heart attack.
* Smoking cuts the amount of oxygen reaching tissues. This can lead to a heart attack or stroke. Pregnant women who smoke are more likely to have a miscarriage or stillbirth.
* People with diabetes who smoke are twice as likely to have circulation and wound healing problems. These can lead to leg and foot infections, sometimes requiring amputation.
* Smokers with diabetes are more likely to develop nerve damage (neuropathy) and kidney disease (nephropathy).
* Smoking increases your chances of permanent vision loss or blindness.
* Smoking increases muscle and joint pain.
* Smoking can cause impotence.
* Smokers with diabetes have more problems with dental disease, bleeding gums and ulcers.

Pretty good reasons for PWD to quit (if they haven't already done so!).

But smoking causing diabetes? A newly-published metanalysis says it may well be a risk factor. (See Active Smoking and the Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis.)

Twenty-five studies were analyzed, which included 1.2 million participants. The researchers found that on average, tobacco users have a 44 per cent higher chance of developing type 2 diabetes. The risk of diabetes was greater for heavy smokers (20 or more cigarettes/day) than for lighter smokers, and lower for former smokers compared with active smokers. "What we found is that smoking is indeed associated with the later development of diabetes, and it's a remarkably consistent association in the combined results of these 25 studies," said co-principal author Dr. William Ghali (quoted at the ADA website). "Smoking is often associated with other unhealthy behaviours that can lead to diabetes, including physical inactivity, poor diet and high alcohol consumption," he said. "It might not be the smoking, per se, but those other mediating factors that are related to smoking and separately related to diabetes."

So, what does this mean for readers of this SharePost?

If you already have diabetes, this new information is important to share with family members who smoke. And, if you're still smoking, you really ought to quit to help your health, for reasons I mentioned at the beginning of this essay.

And if you're reading this as a family member of someone with diabetes and are still smoking, here's another reason to quit: to decrease your odds of getting diabetes.