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Smoking May Raise Risk for Diabetes [06/08-2]
Excerpts from: Smoking May Boost Diabetes Risk Nicotine could be the culprit, increasing insulin resistance
By E.J. Mundell Healthday [06/07/04]
Smokers already worried about their risks for cancer and heart disease now have
another reason to quit: Tobacco may raise the risk for type 2 diabetes, say two
new studies.
"This increased risk for type 2 diabetes could be due to increased insulin resistance, which has previously been shown to occur after an acute episode of smoking," said Dr. Valdemar Grill, a professor at both the University of Science and Technology in Trondheim, Norway, and the Karolinska Institute in Stockholm, Sweden.
Experts have long understood that smoking does serious damage to arteries while raising risks for lung cancer. But studies are beginning to suggest it may encourage the development of diabetes, too.
In the latest study, Grill and his colleagues analyzed Norwegian government health data on nearly 39,000 adult men and women tracked over a period of 11 years.
They found that, regardless of gender, age, weight, physical activity and use of alcohol, smokers who smoked at least a pack of cigarettes a day faced a 64 percent higher risk of developing type 2 diabetes compared with nonsmokers.
The vast majority of diabetics -- about 95 percent -- are affected by type 2 diabetes, which develops when the pancreas fails to produce enough insulin to meet the body's demand or when body tissues become resistant to the effects of insulin. As insulin fails, blood sugar rises to unhealthy levels, raising the risks for cardiovascular disease and other health problems. Experts estimate that more than 18 million Americans have diabetes.
According to Grill, previous studies have suggested smoking contributes to insulin resistance. And since similar associations were found in people who used smokeless "snuff" tobacco, "it is likely that it is nicotine, the common substance in cigarettes and snuff, that is the culprit," he said.
Curiously, the Norwegian study also found smoking was associated with lowered risks for two more rare forms of diabetes -- autoimmune diabetes (associated with dysfunction in the immune system), and type 1 diabetes. According to Grill, animal studies have suggested nicotine may actually help prevent the triggers behind autoimmune diabetes.
Another study presented at the meeting seemed to back up the Norwegian findings. Researchers led by Dr. Hsin-Chieh Yeh of the Johns Hopkins School of Public Health examined data on nearly 9,000 older U.S. adults tracked for nine years.
They found that after adjusting for age, sex, race, weight and other factors, long-term smokers faced a 50 percent higher risk of developing diabetes compared with people who never smoked -- with risks rising as the number of years spent smoking increased.
Commenting on the two studies, Dr. Nathaniel Clark, the ADA's national vice president for clinical affairs, admitted he was "a little surprised" by the findings.
Although the findings are too preliminary to prompt any change in official ADA policy when it comes to preventing diabetes, Clark said quitting smoking should be a no-brainer.
"There are so many reasons not to smoke. I can't imagine that a fear of developing diabetes would trump dying from lung cancer, or any of the other terrible things smoking does," he said.
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