Smoking and diabetes

Perhaps no other addiction has been incriminated with different diseases as smoking. Perhaps every system of the body, from head to toe is affected by smoking. Smokers die on an average 8 to 10 years younger than non-smokers. Smokers are 30-40% more likely to develop Type II diabetes. Smoking can also make managing the disease and regulating the insulin levels more difficult because high levels of nicotine can lessen the effectiveness of insulin causing the smokers to need more insulin to regulate blood sugar levels. Smoking is strongly linked with both increased incidence and severity of diabetes. Smoking is found to cause diabetes by insulin resistance as well as decreased insulin released due to the pancreatic beta cell damaged by the inflammatory and oxidative pathway mechanisms. Maternal smoking during pregnancy is associated with increased risk of diabetes later in life. 

Is there a genetic mechanism that links smoking to diabetes?

Yes, smoking is associated with increased and differential DNA methylation of Type II diabetes genes, specially the ANPEP, KCNQ1, ZMIZ1  genes which explains how smoking is associated with long term diabetes risk. 

Smoking is an independent risk factor for diabetic kidney disease. It has profound negative effects on overall eye health, leads to development and progression of numerous eye diseases such as glaucoma, macular degeneration and cataracts. 

It leads to progression of diabetic retinopathy. There is evidence of smoking as an independent risk factor for peripheral neuropathy in diabetic patients. Smoking is a major risk factor for coronary artery disease in non-diabetic as well as diabetic patients. Smoking also increases the risk of stroke in patients with diabetes. Smoking is associated with exacerbation of peripheral artery disease in diabetes. In non-diabetic smokers it predominantly affects the medium sized arteries, whereas in diabetic smokers it also affects the more distal arteries in the arterioles. Presence of smoking in the background of diabetes has a synergistic effect on the peripheral artery disease occurrence and progression. 

What are the risk of smoking and how it causes diabetes

Sustaining damage to cells and tissues increasing risk of inflammation, by introducing free radicals leading to oxidative stress and cell damage, by immune system problem, causing changes in lipid profiles, higher risk of respiratory and other infections, higher risk for cardiovascular disease, heart attack and stroke, risk of foot ulceration, oral  health problems and also may raise risk of glucose intolerance and accumulation of abdominal fat. All these risks can worsen the symptoms and complications of diabetes. Smoking increases the risk of microvascular complications of diabetes like retinopathy and nephropathy. 

Quitting smoking is not easy, but all diabetic smokers should quit smoking or using any type of tobacco products as early as possible. The health benefits of quitting begin right away. People with diabetes who quit have better control over their blood sugars. Studies have shown that insulin can start to become more effective with lowering blood sugar levels eight weeks after a smoker quits. May need several tries to successfully quit smoking. But the benefits are well worth it. So keep trying.