The impact of smoking on the development of diabetes and its complications

Abstract

Diabetes is one of the most common metabolic disorders and emerges secondary to an interaction between genetic, environmental and lifestyle factors. This work provides an overview of the impact of smoking on the development of vascular complications in this condition and also provides an overview of the potential role of smoking in predisposition to diabetes. There are many studies documenting the impact of smoking on health (not focused on patients with diabetes), suggesting that the health exposure in these individuals is at least comparable to that observed in the general population. Distinct studies of smoking in patients with diabetes have unambiguously confirmed an increased prevalence and a higher risk of early death associated with the development of macrovascular complications. Smoking is also associated with premature development of microvascular complications and may contribute to the pathogenesis of type 2 diabetes. It has been shown that smoking is a predictor of the progression of glucose intolerance at both the transition from normoglycaemia to impaired glucose tolerance status and the increased risk of developing diabetes. The mechanisms explaining the relationship between smoking and the development of diabetes are not fully understood, although a number of hypotheses have been put forward. Current evidence indicates that smoking cessation is not only important to prevent macrovascular complications in diabetes, but also has a role in limiting microvascular disease and may also facilitate glycaemic management in this condition.

5. Lifestyle Management:Standards of Medical Care in Diabetes—2019

“…Recent data show tobacco use is higher among adults with chronic conditions (164) as well as in adolescents and young adults with diabetes (165). Smokers with diabetes (and people with diabetes exposed to second-hand smoke) have a heightened risk of CVD, premature death, microvascular complications, and worse glycemic control when compared with nonsmokers (166,167). Smoking may have a role in the development of type 2 diabetes (168-171).…”

HDL cholesterol is an independent predictor of β‐cell function decline and incident type 2 diabetes: A longitudinal study

“…The observation that low HDL‐C levels are an independent contributor of β‐cell function decline over time, coupled with the evidence that elevation of HDL‐C results in an improved insulin secretion in both patients with type 2 diabetes and healthy volunteers, raises the intriguing possibility that lifestyle and pharmacological interventions able to increase HDL‐C levels may not only improve glycaemic control in subjects with type 2 diabetes but also prevent or delay diabetes development in high‐risk subjects. Consistent with this view, there is evidence indicating that exercise training, quitting smoking and treatment with bezafibrate, a peroxisome proliferator‐activated receptor‐α agonist, all of which are associated with an increase in HDL‐C levels, may hamper type 2 diabetes onset.…”

Frequency of Diabetes Foot Ulcer and Related Factors Among Adult Diabetic Patients in the Diabetes Center of Kerman, Iran

“…It is well established that serious factors play an important role in developing DFU, such as decreased blood flow in extremities, peripheral angiopathy, and peripheral neu- ropathy, that are more common in smokers (13,25,26). Furthermore, some studies have reported that smoking aggravates glucose hemostasis and accelerates the onset and progress of microvascular and microvascular diabetes complications (27,28).…”