Type 2 diabetes, characterized by insulin resistance and/or abnormal insulin secretion and increased glucose production, continues to expand unabated throughout the world. The development of new diabetes can be attributed to decreased physical activity, decreased functional capacity, increased body mass index, preexisting glucose and insulin abnormalities, advanced age and heredity.
Both diabetes and smoking are well-recognized major risk factors for accelerated atherosclerosis and coronary artery disease. However, the possible contribution of cigarette smoking to development of type 2 diabetes has not been specifically investigated.
A recent study published in the October issue International Journal of Cardiology was aimed to evaluate the association between cigarette smoking and development of type 2 diabetes in patients with coronary artery disease and decreased functional capacity over a 6.2-year follow-up period.
The subjects comprised of 630 nondiabetic patients aged 45-74 years, with a fasting blood glucose of <126 mg/dl and with impaired functional capacity. The subjects were classified into two groups: non smokers and smokers. Smokers were younger but they had a relatively unfavorable lipid profile. No significant differences between the groups were found for weight, body mass index, total cholesterol and blood pressure. During the follow-up, development of new diabetes was recorded in 98 patients: in 80 (14.5%) non smokers and in 18 (23.1%) smokers.
The results of this study, conducted in Israel, indicate the current smoking is associated with an independent two-fold increased risk for development of type 2 diabetes in patients with impaired functional capacity.
This, and other such studies conducted, suggests that the majority of cases of type 2 diabetes could be prevented by weight loss, regular exercise, modification of diet, abstinence from smoking, and the consumption of limited amounts of alcohol.