The magnitude of the damage from smoking is often under-appreciated in patients with diabetes mellitus. For people who have diabetes, smoking can increase the risk of diseases that already occur more often in diabetics. For example, there is a substantial increase in cardiovascular disease in diabetics who smoke. Smoking is associated with increases in total cholesterol and very low density lipoprotein cholesterol (bad cholesterol) and a decrease in high-density lipoprotein cholesterol (good cholesterol). In addition, smoking hurts blood circulation by damaging the endothelium (interior surface of the blood vessels). Diabetic smokers have a greater degree of insulin resistance and poorer blood sugar control. Diabetes and smoking leads to increased risk of neuropathy (damage to the nerves), poorer wound healing and end-stage renal disease.
All the risks of having diabetes are magnified by smoking. If you have diabetes and you smoke, it is especially important to stop smoking as soon as possible.
Just as the damage from smoking can be worse for people with diabetes, the health benefits from stopping smoking also are magnified. Circulation improves, risk of heart attack decreases, insulin resistance is lessened, and wound healing is improved.
If you have diabetes and have had a difficult time stopping smoking, try again. Get the help you need. Counseling and medication are effective tools that increase success. Go to www.becomeanex.org and begin making your plan to re-learn life without cigarettes.
Dr. Richard D. Hurt is an internationally recognized expert on tobacco dependence. A native of Murray, Kentucky, he joined Mayo Clinic in 1976 and is now a Professor of Medicine at its College of Medicine. In 1988, he founded the Mayo Clinic Nicotine Dependence Center and since then its staff has treated over 33,000 patients for tobacco dependence. Send your questions directly to Dr. Hurt at AskTheExpert@becomeanex.org
