Type 2 Diabetes Risk Factors: Smoking

By Richard Asa @RickAsa
July 28, 2015
Elderly Patient Wearing Oxygen Mask and Smoking Cigarette --- Image by © Roy McMahon/Corbis

Among the many type 2 diabetes risk factors, smoking both increases your chances of developing this disease and makes your diabetes harder to control.

Bill, by his own admission, was stubborn. He had diabetes and was told repeatedly by his doctor that smoking would worsen his symptoms.

At age 37, he lost vision in his left eye. After that, his kidneys failed and he went on dialysis. He finally quit smoking at age 39 after his leg was amputated because of poor blood flow.

He also developed heart disease – and died at age 42 in 2014.


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Research has found that smoking is one of the type 2 diabetes risk factors. The more your smoke, the higher your risk. Once you have heart and kidney disease, decreased blood flow to the legs and feet, and the development of retinopathy (which can cause blindness).

How smoking affects your nerves

The risk of damage to the nerves in your arms and legs also increases (peripheral neuropathy), causing numbness, pain, weakness and poor coordination. Many people who are also obese develop a foot deformity that can lead to amputation.

A big part of Bill’s legacy was his courage. He went public to implore smokers to quit. "Having diabetes and being a smoker – my doctors always warned me about the bad things that could happen. Did I listen? No,” he told the Centers for Disease Control and Prevention.

Bill wanted you to quit because he knew – and had been told – that if you quit smoking your health will unquestionably benefit. When you quit you have better control of your blood sugar levels, a critical aspect of controlling diabetes itself.

How smoking affects insulin

Smoking affects the way insulin works in your body. In type 2 diabetes, your body does not respond to the insulin, which helps blood glucose enter your body’s cells for fuel. When you smoke, your body is even less able to respond to insulin. This resistance doesn’t start to reverse until you don’t smoke for 10 to 12 hours.


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How to reduce diabetes risk

Controlling your diabetes and smoking cessation are really two separate issues that overlap. When you have diabetes, you have to be constantly vigilant of the factors that can lead to it worsening, such as diet and a sedentary lifestyle. Smoking is like throwing fuel on a fire.

You need a smoking cessation program to quit. Slapping a nicotine patch on your arm can’t hurt, but your chances of long-term success are much higher when you also deal with the important behavioral issues that make quitting harder or easier.

“Several treatment characteristics have been identified as critical to achieve cessation,” a paper by the American Diabetes Association says. “These characteristics include brief counseling by multiple health care providers, use of individual or group counseling strategies, and use of pharmacotherapy.”

One problem with smoking cessation is that it has its own side effects. Many people who quit struggle with weight gain and already had concurrent depression. You may become discouraged after you quit smoking because of the weight gain, while the depression can make relapse more likely.   

While it’s not easy, these factors can be controlled with help from nutritionists and therapists who can help you control your diet and eat healthy foods, and provide practical advice on using behavioral tools that work when you feel the craving to smoke. Your doctor can also give you a prescription for smoking cessation medication.

“Smoking cessation is associated with weight gain and a subsequent increase in risk of diabetes, but in the long term, the benefits of giving up smoking outweigh the adverse effects of early weight gain,” a study in Diabetes Care says.

In the long term, if you do gain weight while quitting smoking your blood glucose levels do gradually decrease. A study found that within three years, diabetics who quit smoking had blood sugar levels similar to the people who kept smoking.

There are many resources that can help you quit smoking, even some tailored to specific age groups. If you have turned to e-cigarettes as a cessation method, you need to know that they contain the same addictive nicotine, so you don’t know how much nicotine they contain, and they haven’t been shown to help you quit smoking.

Bill left four kids and a wife behind. When you consider his story, perhaps that may be motivation enough to quit. If not, also keep in mind that when you quit, you do more than reduce your risk of diabetes and increase your control of it. Smoking harms nearly every organ in the body and causes many diseases that can be fatal.


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February 28, 2020

Reviewed By:  

Janet O’Dell, RN