‘Smokers are three times more at risk of diabetes than non-smokers’

Tobacco claims nearly six million lives every year. According to the World Health Organisation (WHO), more than five million of these deaths are the result of direct tobacco use, whereas second hand smoke causes more than 600,000 premature deaths in non-smokers.

The effects of smoking are deadly. It can affect almost every organ of the body. The effects of tobacco use are even more deadly in people with diabetes. Because nicotine in tobacco increases blood sugar levels among smokers with diabetes. High blood sugar levels in return can increase the risk of serious diabetes complications like heart attack, stroke, kidney failure and nerve damage.

On the occasion of World No Tobacco Day (WNTD), which falls on May 31, Dr K Vijay Kumar, MBBS, MD (Internal Medicine), Consultant Physician and Diabetologist, Multi-speciality hospitals, Bangalore, talked to Salome Phelamei of Zee Media Corp on why tobacco use is particularly bad for people with diabetes.

Dr K Vijay Kumar is a Life Member of Research Society for Study of Diabetes in India and the Indian Medical Association.

Every year, on May 31, the World Health Organisation (WHO) and partners celebrate WNTD, highlighting the health risks associated with tobacco use and advocating for effective policies to reduce tobacco consumption.

Below are excerpts from the interview:

Does tobacco use increase the risk of diabetes?

Yes. Tobacco can increase blood sugar levels and also lead to resistance of insulin in the body. Studies have shown a dose-responsive increase in the relative incidence of diabetes in smokers, and that smokers are three times more at risk of diabetes than non-smokers.

Why is smoking particularly bad for diabetics?

Diabetes is a chronic disease and if not managed properly can lead to long-term complications such as heart disease, kidney disease (nephropathy), nerve disease (neuropathy), eye disease (retinopathy) and foot disease. Smoking combined with diabetes increases the risk and severity of diabetes complications.

Smoking can in fact accelerate the onset of diabetes related complications due to its metabolic effects in combination with increased inflammation and endothelial dysfunction (damage to the inner lining of blood vessels).

What are the harmful effects of smoking with diabetes?

As smoking increases blood sugar levels, maintaining good blood sugar count can be difficult for smokers. It is clearly established that smoking is a fairly large and independent risk factor for heart disease, stroke and peripheral vascular disease in people with diabetes. Smokers are also more at risk for nerve and kidney damage.

How does smoking increase heart disease risk in diabetics?

About 20% of deaths from heart diseases are attributed to smoking. Smokers are three times more likely to die from heart diseases than people with diabetes who are non-smokers.

Smoking can damage the lining of the blood vessels and cause the build-up of fatty deposits in the arteries (atherosclerosis).

It raises the heart rate and blood pressure by causing narrowing of the blood vessels (vasoconstriction). It increases the likelihood of forming blood clots in the arteries leading to heart attacks. It reduces the flow of oxygen to the heart and damages the heart muscles.

Suggest some tips for quitting smoking

Quitting smoking can be difficult, but it is not impossible. Ex-smokers enjoy a better quality of life, have fewer diseases and also an increased lifespan compared to those who continue to smoke.

Here are five simple steps to get you started:

Talk to your doctor and create a quit plan. Ask about nicotine replacement therapy (NRT).
Talk to your friends and family about your quit day. Ask them for support.
Never stay bored. Get busy. Try to get out of your home and go for a walk or exercise if you feel alone and bored.
Avoid people, places, materials and situations that can trigger your smoking urge.
Stay positive. Whenever you feel like having your next puff, think it is for your own good that you quit. It can be hard but the reward is more than worth it. Your doctor will be the best person to address your concerns and make further recommendations.
There is no evidence that e-cigarettes are a healthier alternative to smoking. Cessation is the best advice.