Risk Factors

Smoking and Diabetes

Did you know?

Smokers with diabetes! Did you know that quitting smoking now could dramatically improve your ability to control diabetes? It is critical that you stay in communication with your doctor, as he may want to change your insulin dose or diabetes pill schedule. Similarly, if you are being treated for high blood pressure or high cholesterol levels, your condition may improve so much that your doctor may want to change your treatment

Smoking doubles damage to diabetics

Smoking doubles the damage to the body caused by diabetes by causing hardening of the arteries. This particularly affects the body's larger arteries to the legs and brain, making amputation and strokes more likely.

Researchers have also discovered smoking triples the retinopathy progression rate. The harmful effect does not depend on whether you smoke cigarettes, a pipe, or cigars, but is more dependent on the amount you smoke.

Top Ten Way Smoking hurts Diabetics

• Smoking cuts the amount of oxygen reaching tissues. The decrease in oxygen can lead to a heart attack, stroke, miscarriage or stillbirth.
• Smoking increases your cholesterol levels and the levels of some other fats in your blood, raising your risk of a heart attack.
• Smoking damages and constricts the blood vessels. This can worsen foot ulcers and lead to blood vessel disease and leg and foot infections. Of people with diabetes who need amputations, 95 percent are smokers.
• Smokers with diabetes are more likely to get neuropathy (nerve damage) and kidney disease.
• Smokers get colds and respiratory infections easier causing fluctuation in the glucose levels.
• Smoking doubles your risk of getting limited joint mobility.
• Smoking can cause cancer of the mouth, throat, lung, and bladder.
• People with diabetes who smoke are three times as likely to die of cardiovascular disease, as are people with diabetes who do not smoke.
• Smoking increases your blood pressure.
• Smoking raises your blood glucose level, making it harder to control your diabetes.

Your partner

Your partner develops a quarter of the harmful effects you experience. If you smoke 20/day, this is equivalent to your partner smoking 5/day.

5 cigarettes a day equivalent increases your partners disease rate by 12-25% or more (cataracts, heart disease, strokes) etc. The exact figures are not known.

How to stop

• Prepare to stop Be sure you want to stop, know why you want to, be ready, have a plan. You can stop, although it can be very hard trying.
• Most smokers go through a cycle preparing-stopping-relapsing before finally stopping.
• Think of the reasons the reasons you want to continue, and the reasons why you want to stop.
• Problems or excuses Stress, weight, 'too late', will power, withdrawal symptoms, stop suddenly or gradually. Understand your habits.
• Throw away the day before
• The day before you want to stop throw away any cigarettes you have
• Stock up
• Stock up on sugar-free gum, raw vegetables, or fruit to munch instead.
• Set a date Set a date, and think of all the reasons you want to stop, and write them down.
• Keep thinking of these over the next few weeks.
• Relax Join yoga tai chi or other relaxation classes, or read how to relax in the library.
• Exercise, such as walking, swimming, or dancing may help some people... but start gently.
• Tell everyone Tell your friends you want to stop and ask for their support.. so they do not keep offering you cigarettes.
• Extra support If you think you are addicted to cigarettes, and especially if you started age 14 or less, patches or other nicotine replacements may help.
• Ask your pharmacist for advice.
• How will you cope? Think about how you will cope in the pub or with friends or at work.
• Recent research has identified factors that help people be happy: exercise, learning new things, music and comedy, and making new friends participating in new activities.
• A new hobby A new hobby can help.. what are your interests.. a holiday with the savings?

Lozenges and other nicotine replacment therapy

See here for details about new lozenges that you can suck instead of smoking a cigarette. They contain nicotine, and are rumoured to be very helpful in helping you to stop smoking. They are available from any chemist. Another helpful site, here

Side effects for all formulations: sore throat, hiccups, indigestion, nausea, headache, palpitations (but without hiccups for the inhalator and plus itching, erythma, and rash for patches).

Nicotine Addiction, assessing dependance & motivation to stop

Essentially the degree of addiction can be judged by the

• Number of cigareetes smoked/day
• The time to light the first cigarette first thing in the morning

Suggested phrasing in consultations

The best thing you can do for your health is to stop smoking, and I would advise you to stop as soon as possible."

Tobacco is very addictive, so it can be very difficult to give up, and many people have to try several times before they succeed. If you are ready to try to give up smoking now, then the best thing is to see a counsellor as soon as possible and go ahead.

The best thing is to get counselling from experts, but if this isn't possible, you should make sure that you have good information on the health effects of smoking and some tips on ways of stopping smoking and that you know where to turn for further help and support.

"How do you feel about your smoking?"

"How do you feel about tackling your smoking now?"

Strategies used in intensive behavioural support

• Review smoking history—number smoked per day, time of first cigarette in the day. Ask smoker to keep diary of activities that coincide with smoking
• Review smoking behaviour—past quit attempts, what helped, and reasons for failure
• Emphasise need for total abstinence
• Emphasise need to combat psychological and physical nicotine addiction, where appropriate
• Identify triggers to smoking and encourage smoker to develop strategies for countering these (for example, avoid places or activities associated with smoking)
• If relevant, encourage smoker to develop strategies for avoiding relapse when drinking alcohol
• Encourage appropriate action: set quit date, inform or enlist support of peer group or family, and prescribe nicotine addiction treatment
• Follow up to review progress and prescribe or issue nicotine addiction treatment