Skip to main content

Smoking Causes Diabetes

Active smokers have a 30% to 40% higher risk of developing type 2 diabetes compared with nonsmokers, according to new data published in the Surgeon General's 50-year anniversary report on smoking.
The Health Consequences of Smoking — 50 Years of Progress , announced at the White House last Friday by current acting Surgeon General Boris Lushniak, MD, MPH, highlights diabetes as one of several new diseases causally linked to smoking.

Newer studies have controlled for those and other co founders and have also demonstrated a dose-response relationship, as well as a reduction in diabetes risk following smoking cessation.

So now, the Surgeon General report concludes: "The evidence is sufficient to infer that cigarette smoking is a cause of diabetes."

"The link between smoking and diabetes is really interesting," Serena Tonstad, MD, PhD, MPH, professor at the School of Public Health, Loma Linda University, California, told Medscape Medical News.


Epidemiologic and Biological Evidence

The new report includes a meta-analysis, which updates a 2007 systemic review by adding a further 24 studies. All were prospective cohort studies, and none included individuals who already had diabetes at baseline. In all, the meta-analysis included over 3.9 million subjects, of whom 140,813 subsequently developed diabetes.

The various studies adjusted for many potential confounders, including age, body mass index, physical activity, diet, alcohol consumption, family history of diabetes, gender, race/ethnicity, and educational level.
Compared with nonsmokers, the smokers had a pooled risk ratio for developing type 2 diabetes of 1.37.

Stronger associations were seen in studies that used blood glucose measures to assess the presence of diabetes, rather than in those that relied on patient or physician reports.

A dose-response analysis provides further proof of direct causation. Compared with never-smokers, the relative risk for developing diabetes increased with smoking intensity from 1.14 for former smokers to 1.25 for light smokers (0 – 19 or 0 – 15 cigarettes/day in the various studies) to 1.54 for heavy smokers ( > 15 or > 20), all statistically significant. 

A third line of evidence for causation comes from 4 studies on smoking cessation. One review found improved insulin sensitivity among individuals who quit smoking, despite weight gain.

Another large study found that the risk of incident type 2 diabetes among those who quit smoking actually increased in the short term but fell to that of never-smokers by 12 years after cessation, while another found that the risk fell to that of never-smokers after 5 years for women and 10 years for men.
Due to "limited evidence," however, the report does not discuss the effects of passive smoking on diabe­tes or the adverse effects of smoking on the development of diabetic complications.

But the new Surgeon General's report does provide several possible biologic mechanisms for the causal connection between smoking cigarettes and the development of type 2 diabetes.

For one, smoking promotes central obesity, a well-established risk factor for insulin resistance and diabetes. This effect may be related to higher cortisol concentrations and the differential effect of smoking on sex hormones, the data indicate.

Smoking also increases inflammatory markers and oxidative stress, both implicated in the development of insulin resistance and abnormal glucose metabolism.
And both human and animal studies have found functional nicotinic receptors on pancreatic islet and beta cells. Nicotine could, at least in part, reduce the release of insulin via islet-cell receptors. Animal studies also suggest that prenatal or neonatal exposure to nicotine can cause beta-cell dysfunction and apoptosis, according to the report. Source:
medscape.com
The Health Consequences of Smoking — 50 Years of Progress. published online January 17, 2014.
Report

Comments

Post a Comment

Popular posts from this blog

Reasons Why Your Hips Hurt

Hips Don't lie Inside the Joint Each hip is a ball-and-socket joint. The ball is the top of your thighbone (femoral head). The socket (acetabulum) is in your pelvic bone. Smooth, slippery tissue called cartilage lets the ball and socket glide against each other when you move. A thin lining (synovium) tops the cartilage and makes a bit of synovial fluid, which further eases rubbing.  Tendons, ligaments, and muscles complete the joint. Osteoarthritis It’s the “wear and tear” type of arthritis that many people get in middle age. Cartilage on the ball end of the thighbone and in the hip socket slowly breaks down and causes grinding between bones. You’ll have stiffness, and you might feel pain in your crotch and at the front of your thigh that radiates to your knee and behind. It’s often worse after a hard workout or when you don’t move for a while. Rheumatoid Arthritis With RA, your immune system attacks parts of your body, which can include the syn...
Post a Comment
Read more

Anesthesia Before Age 2 Linked to Learning Problems

There are new concerns about an increased risk for learning problems in very young children exposed to general anesthesia during surgical procedures. Researchers from the Mayo Clinic in Rochester, Minn., found a twofold increase in learning disabilities in children who had more than one exposure to general anesthesia with surgery before age 2. The study is published in the November issue of Pediatrics. The FDA requested and funded the study. Last spring, an FDA panel met to review the research examining the effect of early exposure to anesthesia on the developing brain. Following the meeting, FDA director of anesthesia and analgesia products Bob Rappaport, MD, wrote that additional studies are needed. He noted that "at present, there is not enough information to draw any firm conclusions" about the long-term impact of early exposure to general anesthesia on the brain. The new study adds to the evidence linking repeated exposure to general anesthesia very early i...
Post a Comment
Read more

FDA: 5 Death Reports for Monster Energy Drink

  The FDA is investigating reports of five deaths and a nonfatal heart attack in people who drank high- caffeine energy drinks made by the Monster Energy Company. Meanwhile, a Maryland couple has filed a wrongful death suit against the company, alleging that their product killed their 14-year-old daughter. They say Anais Fournier, 14, collapsed after drinking her second 24-ounce Monster Energy drink in two days. She died six days later. The reports are not proof that the drinks caused the deaths, but merely signal there might be a problem. Even if the deaths are determined to be caused by caffeine poisoning, the FDA will consider all sources of caffeine before blaming the deaths on the energy drink. In addition to caffeine, energy drinks contain other stimulants, including taurine and guarana , a caffeine-containing plant. Because energy drinks are sold as nutritional supplements, they are not regula...
Post a Comment
Read more