Smoking increases the risk of developing type 2 diabetes. For people who already have diabetes, smoking makes the condition harder to manage and increases the risk of serious complications. However, quitting smoking can make a real difference to both the prevention and management of the disease.
Does smoking increase the risk of diabetes?
Yes, research has established that cigarette smoking increases the risk of developing type 2 diabetes. People who smoke are approximately 30–40% more likely to develop the disease than non-smokers. The risk also increases with the number of cigarettes smoked. Even passive smoking is associated with an increased risk of type 2 diabetes.
The main reason is the chemicals in cigarette smoke, which interferes with the way the body uses insulin. Insulin is a hormone produced by the pancreas that allows glucose (sugar) to move from the blood into the body’s cells, where it is used for energy. When cells become less responsive to insulin, a condition known as insulin resistance develops. Blood sugar levels rise, and the pancreas has to work harder to produce enough insulin.
The chemicals in cigarette smoke cause inflammation and damage to cells, interfering with the body’s ability to regulate blood sugar. Smoking is also associated with increased abdominal fat, another risk factor for type 2 diabetes.
The link is not limited to heavy smokers. Even people who smoke relatively few cigarettes have an increased risk.
Why is smoking particularly dangerous for people who have diabetes?
Having diabetes already increases the risk of cardiovascular disease, kidney problems, nerve damage and vision loss. Smoking adds to these risks, making the combination particularly harmful.
One important problem is blood sugar control. The chemicals in cigarette smoke raise blood sugar and make the body less sensitive to insulin. As a result, smokers with diabetes may need more insulin or other medication to keep their glucose levels under control.
Smoking also damages blood vessels and reduces circulation. This is especially concerning in people with diabetes, who are already more vulnerable to damage to their arteries and small blood vessels.
The combination of diabetes and smoking substantially increases the risk of heart attack and stroke. It also increases the likelihood of kidney disease and damage to the blood vessels in the eyes, which can eventually lead to blindness.
Poor circulation is particularly dangerous in the legs and feet. People with diabetes may already have reduced sensation because of nerve damage. When smoking further reduces blood flow, even a small wound or blister can become difficult to heal. Infections and foot ulcers may develop, sometimes leading to amputation.
Smoking can also worsen diabetic neuropathy, a condition involving damage to the nerves that can cause pain, tingling and numbness, particularly in the feet and legs.
In short, smoking makes an already serious disease considerably more dangerous.
What happens when someone with diabetes quits smoking?
Quitting smoking is one of the most important steps a person with diabetes can take to protect their health. The benefits begin soon after the last cigarette, even in people who have smoked for many years.
When exposure to smoke stops, the body gradually becomes more responsive to insulin. Blood sugar levels may become easier to control, and some people find that their diabetes medication requirements change.
Research has found that insulin can become more effective within approximately eight weeks of quitting smoking. Over time, stopping smoking also reduces the additional cardiovascular and vascular risks associated with tobacco use.
Better circulation can help protect the feet and legs, while reducing the risk of heart disease, stroke and further damage to the kidneys and eyes.
There is one important point to bear in mind. Some people gain weight after quitting smoking, which can temporarily affect blood sugar levels. The risk of developing type 2 diabetes may also remain elevated for a period after cessation, partly because of weight gain. However, research shows that this risk decreases with time since quitting. The long-term health benefits of stopping smoking are substantial.
People with diabetes who quit should monitor their blood sugar regularly, particularly during the first weeks and months. Their doctor may need to review their medication or adjust their treatment as their glucose levels change.
Quitting does not cure diabetes or reverse existing organ damage, but it can make the disease easier to manage and reduce the risk of further complications.
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References
- Centers for Disease Control and Prevention (CDC). Diabetes and Smoking. Read more.
- US Food and Drug Administration (FDA). How Smoking Can Increase Risk for and Affect Diabetes. Read more.
- Pan A, Wang Y, Talaei M, Hu FB, Wu T. Relation of active, passive, and quitting smoking with incident type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015 Dec;3(12):958-67. https://doi.org/10.1016/s2213-8587(15)00316-2
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