Diabetes and Cigarette Smoking

There are numerous reasons to avoid or stop smoking cigarettes, and diabetes is unquestionably one of them. Whether you have type 1 or type 2 diabetes or want to avoid developing type 2 diabetes, quitting smoking is an important part of your long-term health.

In fact, the more cigarettes you smoke per day, the more likely you are to develop type 2 diabetes. You are 30 to 40% more likely to develop diabetes if you smoke than if you don't.

In this article, we'll look at why smoking raises your risk of developing type 2 diabetes and causes diabetes-related complications.

How cigarettes increase your chances of developing diabetes, insulin resistance, and complications

Cigarette smoking worsens blood sugar levels and overall insulin resistance in four ways:

  • Nicotine reduces the effectiveness of insulin.
  • Smoking causes systemic inflammation.
  • Tobacco use causes oxidative stress (which leads to complications)
  • Cortisol and belly fat levels rise.

Let's take a closer look at this.

Reduces the effectiveness of insulin

Whether you are a non-diabetic or have been diagnosed, cigarette smoking has a significant impact on your insulin sensitivity, greatly increasing a non-risk diabetic's of developing type 2 diabetes.

Every time your body is exposed to nicotine, it significantly increases your insulin resistance. After smoking one cigarette, nicotine leaves your body in 8 to 48 hours.

According to a 2017 Japanese study, “we discovered a linear dose-response relationship between cigarette consumption and type 2 diabetes risk; the risk of type 2 diabetes increased by 16 percent for each increment of 10 cigarettes smoked per day.”

“The risk of type 2 diabetes remained high among those who quit within the previous 5 years, but decreased steadily with increasing duration of cessation, reaching a risk level comparable to never smokers after 10 years of smoking cessation.”

The researchers concluded that smoking cigarettes was responsible for an estimated 18.8 percent of men and 5.4 percent of women with type 2 diabetes.

Simply put, when you have nicotine in your system, insulin is less effective. The more you smoke, the more insulin you'll need to keep your blood sugars under control.

Inflammation throughout the body

Smoking also contributes to insulin resistance by causing widespread inflammation throughout the body.

According to the CDC, “inflammation occurs when chemicals in cigarette smoke injure cells, causing swelling and interfering with proper cell function.”

Further research has only recently revealed the precise mechanism by which this inflammation develops.

“Scientists have discovered that nicotine activates certain white blood cells known as neutrophils, which then release molecules that cause increased inflammation,” according to a 2016 study published in the Federation of American Societies for Experimental Biology.

This study also provided experts with a better understanding of the link between smoking and autoimmune diseases.

“Because of the direct link between nicotine and inflammation, this study has important implications, including the possibility that alternative forms of nicotine inhalation, such as vaping, which lacks other chemicals found in cigarette smoke, may still have negative immunological effects.”

It causes oxidative stress (which leads to complications)

“Smoking also causes oxidative stress, a condition that occurs in the body when chemicals from cigarette smoke combine with oxygen.”

This combination then causes additional cell damage throughout your entire body.

This is the primary reason why smoking increases the risk of developing diabetes complications in people with any type of diabetes.

According to a 2018 Australian study, “it is becoming clear that oxidative stress and inflammation are significant risk factors for the development and sustained cellular injury of type 1 and type 2 diabetic complications.”

“This is true for all diabetic complications, such as diabetesassociated atherosclerosis with its underlying endothelial dysfunction, diabetic nephropathy, diabetic retinopathy, and diabetic cardiomyopathy.”

In 2017, additional research from Poland found more evidence concluding a direct link between smoking and complications.

“Numerous studies of smoking in diabetic patients have unequivocally confirmed an increased prevalence and a higher risk of premature death associated with the development of macrovascular complications.”

Cortisol and belly fat levels rise.

It has been linked to increased belly fat, obesity, and cortisol levels, in addition to increasing insulin needs. All of this contributes to insulin resistance.

“Although smokers have a lower mean BMI than nonsmokers, heavier smokers have a more metabolically adverse fat distribution profile, with higher abdominal and visceral adiposity than lighter smokers,” explains a South Korean study published in 2012. “This finding reflects the metabolic effects of smoking.”

The effect of smoking on cortisol production may appear minor at first, but it has a significant impact on people who have or are at risk of developing type 2 diabetes.

“The effect size of smoking on cortisol secretion is small to moderate,” explains the Journal of Clinical Endocrinology and Metabolism, “but this consistent effect every day over many years may potentially have large consequences on downstream endocrine function.”

“For example, evidence suggests that the moderately elevated cortisol levels seen in smokers could have significant effects on glucose and insulin metabolism.”

Cigarettes are extremely addictive, regardless of the facts or research. This means that, regardless of how well you understand their negative impact on your health, quitting them completely means overcoming the numerous side effects of nicotine withdrawal.

Top smoking cessation advice for diabetics

When it comes to quitting smoking, one of the most common concerns is weight gain. That concern is amplified if you have diabetes.

The Cleveland Clinic's Tobacco Treatment Center offers the following tips for quitting smoking without gaining weight:

Expect a significant increase in your appetite.

When you stop smoking, your appetite will increase dramatically. You should be prepared for this and have a plan in place that is more than just willpower. Willpower is depleted. Instead, eat a small meal or snack every 3 to 4 hours to keep yourself well-fed.

Choose whole foods (ie: real food) over processed, packaged foods, and remember to include fat or protein with each meal.

Snacks could include an apple with peanut butter or baby carrots with cheese, for example.

Meals should include a variety of fiber-rich, chewy vegetables, as well as protein and a small portion of whole grains if they are already a part of your diet and you know your blood sugar can handle them!

The more real food you can put in your stomach, especially vegetables, the more stable your blood sugar will be and the less likely you will gain weight.

Don't forget about the water! Drink, drink, and more drink. A well-hydrated body craves far fewer junk foods than a dehydrated body. Drinking water can also help to distract you from your cravings.

Begin exercising on a daily basis.

When nicotine is present in the body, your metabolism temporarily increases. When you stop smoking, your metabolism returns to its normal, natural rate. To compensate — and keep your metabolism burning — you should start exercising regularly.

Exercise will also play an important role in restoring your overall health, particularly your insulin sensitivity and blood sugar levels.

It doesn't have to be outlandish. Simply get up and go for a 15- to 30-minute walk once a day, either during your lunch break, after work, or after dinner. Get to your feet. Get your feet moving.

Create a new routine for yourself during the times of day when you used to smoke.

You're probably used to smoking after a meal to signal to your body that the meal is finished and you can stop eating. Without it, you may find yourself wanting to eat and eat and eat.

Or perhaps you smoked as an excuse to get some fresh air in the middle of your workday?

Create new rituals and routines for the times of day you used to smoke instead. Instead of standing outside the building, take a brisk walk. After dinner, chew a piece of minty gum. Brush your teeth after each meal to achieve the “you're done eating” sensation.

If you can recall all of your routines that revolved around the act of smoking cigarettes, write them down and begin creating new ones. Willpower alone is insufficient.

Fill your hands and mouth with healthier foods.

Smoking, like your routines, provided you with something to do with your mouth and hands (and perhaps your anxious energy).

You may need to chew on raw vegetables (carrots or celery), chew gum, or carry a pack of mints with you at all times.

Remind yourself that the advantages of quitting outweigh any weight gain.

Even if you gain a little weight after quitting, the benefits of getting cigarettes out of your body and life far outweigh the disadvantages of weight gain.

According to the American Lung Association, cigarettes contain approximately 600 ingredients. “When cigarettes are burned, they emit over 7,000 chemicals. At least 69 of these chemicals have been linked to cancer, and many are highly toxic.”

If you use insulin or any other diabetes medication…

Within about 2 months of quitting smoking, your insulin needs may begin to decrease, which may result in more low blood sugars. If you eat and snack more, you may be able to avoid those lows.

Regardless, consult with your doctor during the first month of quitting smoking to discuss any necessary adjustments to your insulin doses. The more you share your goal, the more people will support you!

It's time to quit if you're ready to change your life and improve how you feel on a daily basis.

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