Everyone knows that smoking is unhealthy. Despite this, a large number of people smoke but nobody seems to care. While we don′t seem to be very concerned about this aspect of smoking from a moral point of view, many people with diabetes feel that society at large employs double standards by disapproving of them for eating “the wrong sort of food” but completely ignoring people with all sorts of health problems who smoke.
About the same number of people with diabetes smoke as do other people. And smoking results in a substantially increased risk of lung cancer, chronic bronchitis and diseases of the heart and blood vessels. Having diabetes, in itself, puts you at increased risk of heart and blood vessel diseases such as arteriosclerosis, heart attacks and stroke. In diabetes the risks are cumulative. If you imagine diabetes as a balancing act on a slack rope, smoking may be the extra factor that tips you over. Many studies in adults confirm that the risk of premature death for a person with diabetes who smokes is 1.5-2 times that of a person with diabetes who does not smoke. But research also indicates that giving up smoking reduces this risk.
Nicotine from smoking affects the blood glucose level by contracting the blood vessels, resulting in a slower absorption of insulin from the injection site. Nicotine will also cause increased insulin resistance (a poorer blood glucose-lowering effect of a given dose of insulin), which makes diabetes more difficult to manage. The risk of acquiring Type 2 diabetes is twice as high for a person who smokes, especially if that person is a woman.
Smoking causes the inhalation of carbon monoxide, which binds strongly to haemoglobin in the red blood cells and prevents oxygen from binding to them. The number of red blood cells increases to compensate for this. Scientific studies show that in a person with diabetes, smoking increases the risk of renal failure, visual impairment, foot ulcers, leg amputations and heart attacks.
Passive smoking
Even passive smoking can damage your health. It has been shown that children absorb nicotine into their bloodstream at twice the rate of adults through smoking passively. Smaller children are even more sensitive. Children of smoking parents also have increased levels of lead and cadmium in their blood. Smoking near an extractor fan (e.g. in the kitchen) will not prevent smoke from spreading into the house.
Giving up smoking
It may be difficult to give up smoking by yourself. Your diabetes healthcare team can help you with advice and nicotine chewing gum or patches that may be effective. However, unless you are motivated yourself, you will never succeed in giving up! In one study the HbA1c levels decreased from 7.7% to 7.0% in a group of people with diabetes who ceased smoking.
There is a risk that you will put on weight when you stop smoking, but this will not necessarily happen. So it may depend on how you go about trying to give up. You should talk to your diabetes healthcare team for specific advice to maximize your chances of success while minimizing your chances of any adverse effects during the actual process of giving up.