Smoking's Detrimental Impact on Diabetics

Smoking's Detrimental Impact on Diabetics

Smoking, active or passive, significantly compromises health, particularly in individuals with chronic non-communicable diseases (NCDs). Studies indicate that smokers are 30–40% more likely to develop type 2 diabetes compared to non-smokers. In short, the greater the cigarette smoke exposure, the more profound the risk to one’s health.

Smoking raises diabetes risk

According to the American Diabetes Association, diabetes was responsible for over 87,000 deaths in 2019, making it the seventh leading cause of death in the United States. Smoking contributes to an estimated 9,000 diabetes-related deaths annually.

The toxic chemicals found in cigarettes trigger cellular inflammation, impairing the action of insulin. When these harmful substances interact with oxygen in the body, they generate reactive oxygen species and oxidative stress, a state in which free radicals overwhelm the bodily antioxidant defenses. Persistent oxidative stress contributes to the development of type 2 diabetes over time. Moreover, smokers are more likely to accumulate visceral fat, particularly in the abdomen, which further elevates the risk of type 2 diabetes. (Even in individuals with body weight and BMI within the recommended range.)

Smoking increases the risk of complications for diabetics.

Smoking makes diabetes more challenging. The higher the cigarette smoke exposure, the more insulin resistance develops at the cellular level, leading to elevated blood glucose levels. As a result, individuals with diabetes who smoke often require higher doses of insulin to maintain adequate glycemic control, impacting health and substantially increasing the risk of serious complications, including:

• Heart disease: Smoking increases the atherogenic low-density lipoprotein cholesterol level and lowers the beneficial high-density lipoprotein cholesterol level. Over time, elevated cholesterol levels can contribute to the development of coronary artery disease.
• Hypertension: Diabetic patients who smoke are at risk of developing blood vessel damage from vascular inflammation, leading to arterial stiffness and hypertension. 
• Kidney disease: Smoking in people with diabetes is associated with an increased risk of proteinuria—abnormal leakage of protein into the urine—an early marker of diabetic nephropathy, which may ultimately progress to kidney failure. If diabetic patients smoke, they are more likely to experience proteinuria, the leakage of protein into the urine, which can eventually lead to kidney failure.
• Peripheral circulatory impairment: Smoking damages the small blood vessels, compromising blood flow to peripheral organs, particularly the legs and feet. This impaired circulation heightens the risk of chronic, non-healing wounds and infections, potentially leading to limb amputation.
• Nerve damage: Inflammation caused by smoking not only impairs capillary function but also damages peripheral nerves, which can lead to symptoms such as neuritic pain, numbness, or tingling sensations. 
  Quitting smoking would not reverse diabetes or fully restore health due to the chronic inflammation and degenerative changes that characterize the disease.

Nevertheless, giving up smoking can significantly improve diabetes management, help stabilize the disease, and lead to a better quality of life.