The epidemiological evidence linking smoking with insulin resistance is considerable. This evidence is even more convincing because there is a dose response relationship between smoking and the risk of non-insulin dependent diabetes (NIDDM). Similarly, there is a time-dependent decrease in risk of NIDDM for those who quit smoking. Insulin resistance (in the form of impaired glucose tolerance, IGT) may precede the development of NIDDM. There is a biochemical basis for the smoking- IGT / NIDDM relationship.
Smoking increases the risk of developing diabetic complications like nephropathy, neu ropathy and retinopathy. Smoking is also an independent risk factor for myocardial infraction and all-cause mortality in NIDDM.
Smokers are both insulin resistant and lipid intolerant. Smoking cessation increases circulating high density lipoprotein (HDL) and reduces low density lipoprotein (LDL) levels, despite weight gain.
Those providing advice or treatment to improve cardiovascular risk factors should be aware of these smoking-related harmful effects. This is especially true if IGT is underdiag nosed despite the fact that this condition increases the risk of vascular events. Explaining that smoking increases the chance of developing diabetes as well as raising 'blood fat' levels may convince more smokers to quit.
Anzalone DA, Anzalone FL, Fos PJ ( 1995). High-density lipoproteincholesterol: determining hygienic factors for intervention. J Occup Environ Med37, 856 -861.
2.
Axelsen M., Eliasson B., Joheim E. et al (1995). Lipid intolerance in smokers. J Intem Med237, 449 - 455.
3.
Bainton D., Sweetnam P., Baker I., Elwood P. (1994). Peripheral vascular disease : consequence for survival and association with risk factors in the Speedwell prospective heart disease study. Br Heart J72, 128 -132.
4.
Bretzel RG (1997). Prevention and slowing down the progression of the diabetic nephropathy through antihypertensive therapy. J Diab Complications11, 112-122.
5.
Byrne CD, Wareham NJ, Day NE, McLeish R., Williams DR, Hales CN (1995). Decreased non-esterified fatty acid suppression and features of the insulin resistance syndrome occur in a sub-group of individuals with normal glucose tolerance. Diabetologia38, 1358 - 1366.
6.
Chaturvedi N., Stevens L., Fuller JH (1997). Which features of smoking determine mortality risk in forrner cigarette smokers with diabetes? The World Health Organisation Multinational Study Group. Diabetes Care20, 1266-1272.
7.
Eliasson B., Smith U., Lonnroth P. (1997a). No acute effects of smoking, and nicotine nasal spray on lipolysis measured by subcutaneous microdialysis. Eur J Clin Invest27, 503-509.
8.
Eliasson B., Attvall S., Taskinen MR, Smith U. (1997b). Smoking cessation improves insulin sensitivity in healthy middle-aged men. Eur J Clin Invest27, 450-456.
9.
Eliasson B., Mero N., Taskinen MR, Smith U. (1997c). The insulin resistance syndrome and postprandial lipid intolerance in smokers. Atherosclerosis129, 79-88.
10.
Ernst E., Resch KL (1995). Therapeutic interventions to lower- plasma fibrinogen concentration. Eur Heart J16 (Suppl. A), 47 - 53.
Forrest KY, Maser RE, Pambianco G., Becker DJ, Orchard TJ (1997). Hypertension as a risk factor for diabetic neuropathy : a prospective study. Diabetes46, 665-670.
13.
Greaves M., Malia RG, Goodfellow K., Mattock M., Stevens LK, Stephenson JM, Fuller JH (1997). Fibrinogen and von Willebrand factor in IDDM: relationships to lipid vascular risk factors, blood pressure, glycaemic control and urinary albumin excretion rate: the EURODIAB IDDM Complications Study . Diabetologia40, 698-705.
14.
Hanefeld M., Fischer S., Julius U., et al (1996). Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11-year follow-up . Diabetologia39, 1577-1583.
15.
Heitzer T., Yla-Herttuala S., Luoma J. et al, (1996). Cigarette smoking potentiates endothelial dysfunction of forearm resistance vessels in patients with hypercholesterolaemia. Role of oxidized LDL. Circulation93, 1346 - 1353.
16.
Ikeda Y., Suehiro T., Takamatsu K., Yamashita H., Tamura T., Hashimo-To K. (1997). Effect of smoking on the prevalence of albuminuria in Japanese men with non-insulin-dependent diabetes mellitus. Diab Res Clin Pract36, 5761.
17.
Janzon L., Berntorp K. , Hanson M., Lindell SE, Trell E. (1983) Glucose tolerance and smoking: a population study of oral and intravenous glucose tolerance tests in middle aged men. Diabetologia25, 86 - 88.
18.
Jeremy JY, Mikhailidis DP, Pittilo RM (1995). Cigarette smoking and cardiovascular disease. J Roy Soc Health115, 289 - 295.
19.
Kawakami N., Takatsuka N., Shimizu H., Ishibashi (1997). Effects of smoking on the incidence of non-insulin-dependent diabetes mellitus. Replication and extension in a Japanese cohort of male employees . Am J Epidemiol145, 103-109.
20.
Keller CK, Bergis KH, Fliser D., Ritz E. ( 1996). Renal findings in patients with short-term type 2 diabetes . J Am Soc Nephrol7, 2627-2635.
21.
Koenig W. (1995). Recent progress in the clinical aspects of fibrinogen . Eur Heart J16 (Suppl. A), 54 - 59.
22.
Mikhailidis DP (1995). Smoking and non-insulin dependent diabetes - a causal link? J Smoking-Related Dis6, 77-79.
23.
Miller ER 3rd, Appel LJ, Jiang L., Risby TH (1997). Association between cigarette smoking and lipid peroxidation in a controlled feeding study. Circulation96, 1097-1101. Porkka Kvk, Ehnholm C. (1996). Smoking, alcohol and lipoprotein metabolism. Curr Opin Lipidol7, 162-166.
24.
Price JF, Lee AJ, Fowkes FG (1996). Hyperinsulinaemia: a risk factor for peripheral arterial disease in the non-diabetic general population. J Cardiovasc Risk3, 501-505.
25.
Richard F., Marecaux N., Dal-Longeville J., et al (1997). Effect of smoking cessation on lipoprotein A-I and lipoprotein A-I:A-II levels. Metabolism46, 711-715.
26.
Rimm EB, Chan J., Stampfer MJ, Colditz GA, Willett WC ( 1995). Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ310, 555 - 559.
27.
Rimm EB, Manson JE, Stampfer MJ et al. (1993). Cigarette smoking and the risk of diabetes in women. Am J Publ Health83, 211-214.
28.
Sands ML, Shetterly SM, Franklin GM, Hamman RF (1997). Incidence of distal symmetric (sensory) neuropathy in NIDDM. The San Luis Valley Diabetes Study. Diabetes Care20, 322-329.
29.
Simpson AJ, Gray RS, Moore NR, Booth NA (1997). The effects of chronic smoking on the fibrinolytic potential of plasma and platelets. Br J Haematol97, 208-213.
30.
Sinha RN, Patrick AW, Richardson L., Wallyma- Hmed M., Macfarlane IA (1997). A six-year follow-up study of smoking habits and microvascular complications in young adults with type 1 diabetes. Postgrad Med J73, 293-294.
31.
Smith U. (1995). Smoking elicits the insulin resistance syndrome: new aspects of the harmful effects of smoking. J Intern Med237, 435 - 437.
32.
Stamler J., Rains-Clearman D., Lenz-Litzow K., Tillotson JL, Grandits GA (1997). Relation of smoking at baseline and during trial years 1-6 to food and nutrient intakes and weight in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial. Am J Clin Nutr65 (Suppl A), 374S-402S.
33.
Tesfaye S., Stevens LK, Stephenson JM, et al (1996). Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM Complications Study. Diabetologia39, 1377-1384.
34.
Zoppini G., Targher G., Monauni T., et al (1996). Increase in circulating products of lipid peroxidation in smokers with IDDM. Diabetes Care19, 1233-1236.
