Diabetes Mellitus and Smoking

What is Diabetes?


Diabetes Mellitus is not just one disease but a set of related diseases in which the body cannot regulate the amount of sugar (especially glucose) in the blood. Normally, the pancreas releases a substance, called insulin, into the blood. Insulin helps the body use simple sugars and fats broken down from the food we eat. When a person has diabetes, the pancreas either does not make insulin, doesn’t make enough of it, or the insulin does not work properly.

What causes Diabetes Mellitus?

Type 1 diabetes: Believed to be an autoimmune disease. The body’s immune system attacks the cells in the pancreas that produce insulin.

• A predisposition to develop type 1 diabetes may run in families, but genetic causes (a positive family history) is much more common in type 2 diabetes.
• Environmental factors, including unavoidable viral infections, may also contribute.
• Type 1 diabetes is most common in Caucasian people especially of Northern European descent , followed by African Americans, and Hispanic Americans. It is relatively rare in those of Asian descent.
• Type 1 is slightly more common in men than in women.

Type 2 diabetes: Has strong genetic links, meaning that type 2 tends to run in families. Several genes have been identified and more are under study which may relate to the causes of type 2 diabetes.

Risk factors for developing type 2 diabetes include the following:

• Family history of diabetes mellitus
• Being of African-American, Hispanic, or Native American race or ethnic background
• Obesity (being 20% or more over your desired weight)
• Physical stress (which can include surgery or illness)
• Use of certain medicines
• Injury to the pancreas (can occur from things such as infection, tumor, surgery, or accident)
• Autoimmune disease
• Hypertension
• Elevated blood cholesterol or triglyceride levels
• Age ( Risk increases with age.)
• Alcohol (Risk increases with years of heavy alcohol use.)
• Smoking
• Pregnancy (Women can develop diabetes during pregnancy and this increases the risk of Type 2 diabetes later in life.)

Common symptoms of both major types of diabetes:

• Fatigue
• Unexplained weight loss
• Excessive thirst
• Excessive urination
• Excessive eating
• Poor wound healing
• Infections
• Altered mental status
• Blurry vision

What Happens When You Have Diabetes Mellitus?

• In order to have the energy to perform your daily activities, it is necessary to have glucose in your blood. So glucose is taken from the foods you eat and put into the bloodstream by the liver.

• The level of glucose in the blood is regulated by several hormones including insulin (produced in the pancreas). Insulin allows glucose to move from the blood into liver, muscle, and fat cells, where it is used for fuel.
• People with diabetes either do not produce enough insulin (type 1 diabetes) or cannot use insulin properly (type 2 diabetes).
• Therefore, glucose in the blood cannot move into cells, so it stays in the blood. This not only harms the cells that need the glucose for fuel, but also harms certain organs and tissues exposed to the high glucose levels.

Complications of Diabetes

In the short term, diabetes can contribute to a number of acute (short lived) medical problems.

• The body’s ability to fight infection and to heal is impaired so infections are frequently more dangerous in someone with diabetes. And to make matters worse, infections may worsen glucose control, which further delays recovery from infection.

• Diabetics can also suffer from hypoglycemia (low blood sugar) due to too much insulin, missing a meal, too much alcohol, too much exercise, or taking certain medications.
• Ketoacidosis is a condition in which uncontrolled hyperglycemia over time creates a buildup in the blood of ketones which can be very harmful.

Both forms of diabetes ultimately lead to high blood sugar levels, a condition called hyperglycemia. Over a long period of time, hyperglycemia damages the retina of the eye (leading cause of blindness), the kidneys (leading cause of kidney failure), the nerves (leading cause of foot wounds and ulcers – often leading to amputations), and the blood vessels ( accelerates atherosclerosis which leads to heart attack, stroke and deceased circulation in the arms and legs).

Diabetes predisposes people to high blood pressure and high cholesterol and triglyceride levels. These conditions independently and together with hyperglycemia increase the risk of heart disease, kidney disease, and other blood vessel complications

Diabetes and Smoking

Smoking Increases Your Risk of Getting Diabetes Mellitus

If you smoke, and think you are otherwise in good health, think again. According to a study published is the American Journal of Epidemiology, smoking 16 to 25 cigarettes a day increases your risk for Type 2 diabetes to 3x that of a non-smoker.

Smoking Increases Complications for Those Who Have Diabetes

In addition to increasing your risk for getting diabetes, smoking can also make managing the disease more difficult for those who already have it.

Other complications of smoking and diabetes include:

• Raising of your blood sugar levels AND cuts your body’s ability to use insulin, making it harder to control your diabetes. (Smoking one cigarette reduces the body’s ability to use insulin by 15%.)
• 3X more likely to die of cardiovascular disease. Smoking and diabetes together make you 11X more likely to die of a heart attack or stroke.
• Increased cholesterol levels and the levels of the other fats in your blood. This increases our risk of having a heart attack.
• 2X as likely to have circulation and wound healing problems. This is partly due to the fact that smoking cuts the amount of oxygen needed for wound healing from reaching the tissues. This can lead to leg and foot infections, sometimes requiring amputation.
• Increased likelihood of developing nerve damage and kidney disease.
• Causing impotence
• Increasing muscle and joint pain
• Having more problems with periodontal disease due to impaired healing

A person with some or all of the risk factors might never develop diabetes mellitus, but your chances increase as more risk factors are present. Certain risk factors like age, family history, and ethnicity cannot be altered, but a change in lifestyle that includes eating a modified diet, increasing physical activity, and, most importantly, quitting smoking will help reduce the risk.

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