During initial diabetes office visits and history taking I can go for weeks asking patients if they smoke cigarettes and the answer is an emphatic no! They say they never have and never will. That makes that part of the history intake short because I can exclude all the information about what smoking can do to you and your general health. The last few months those statistics have changed and I have seen a large group of smokers; no real reason why or pattern to it. The range is from middle age to the elderly. Both males and females have shared their need (mental and physical) to smoke with concern about its health impact but with no desire to quit. Since the school year is starting soon and most of these people have shared that they began smoking in middle or high school, I thought it would be a great time to review why smoking is detrimental to anyone’s health especially those with diabetes or pre-diabetes.

  1. Cigarette chemicals definitely have an impact on your lung health with an increase in rates of allergies, asthma, bronchitis, pneumonia, and C.O.P.D., emphysema as well as lung cancer. Lung conditions create a reduced ability to take in oxygen which causes your capacity to be physically fit extremely limited. This has a direct impact on diabetes control since exercise is always your best therapy for insulin resistance which occurs in type 2 diabetes.
  2. Cigarette chemicals have a huge impact on your cardiovascular system as well. A heart attack or MI is one of the leading causes of death in diabetes. Blood vessels can narrow or constrict due to these chemicals. The arteries stiffen; the plaque inside the vessels can accumulate and narrow the inner linings. This prevents the cells from carrying proper amounts of oxygen and the heart must work harder with less efficiency. The toxins in tobacco cause blood clotting which blocks blood flow. The blood pressure goes up (already common in diabetes). The resting heart rate goes up which is a possible sign of premature death in the general population. The LDL or dangerous cholesterol goes up (already common in diabetes) and all this leads to an increase in an aneurysm and heart attack. A heart attack is caused by a blood clot 90% of the time. An aneurysm is a bulge in the artery wall which can eventually tear or rupture leading to death if unrecognized or untreated.
  3. Smoking has an impact on bone health. The bones can weaken since cigarette toxins accelerate bone loss. This increases the risk of fractures and eventual osteoporosis. This can result in broken hips or other bones requiring long periods of recovery and rehab. Inactivity and stress can definitely increase blood sugars and lead to more diabetes complications.
  4. Smoking has an impact on your mouth health. There is decreased blood supply to the teeth and gums due to the cigarette toxins. Eventually this can become periodontal disease which is already a complication with diabetes. People who smoke are at 2 times the risk of losing teeth due to dry mouth and lack of saliva. Many people end up with poor fitting dentures; this leads to trouble chewing and proper nutrition. Diabetes control is dependent on a good balanced food plan.
  5. Smoking can dull your taste buds and sense of smell. That can cause lack of appetite and improper eating patterns leading to blood sugar swings. The good news is that when you stop smoking these senses return quickly. Smoking can also increase your risk of acid reflux, which is a huge problem in America. Acid reflux is also due to eating quickly, drinking too much alcohol and taking multiple medications. Smoking causes the digestive acid to increase and irritate the esophagus and the esophageal sphincter. This means treating with even more medications and more side effects!
  6. Smoking can have an effect on your thought process including reasoning, memory, learning and decision making. Research done in Scotland states it is most likely connected to less circulating oxygen to the brain which causes a reduction in mental abilities.
  7. It may sound superficial but smoking damages skin and leads to more wrinkles.
  8. According to a study in the Journal of the American Medical Association, smokers are 44% more likely to eventually develop diabetes. Smoking increases glucose abnormalities and limits the function of insulin which allows glucose into the cells.

There is so much scientific evidence against smoking, yet patients continue to smoke. It is known to be an extremely addictive drug and difficult habit to break. Talk to your health care provider to get the help you need as soon as possible. Try nicotine patches, pills or gum. Think about hypnosis, acupuncture and biofeedback. Try a free smoking cessation class offered by the American Lung Association. Call 1-877-848-6696 – Quit Smoking Now program and get started. Go cold turkey with support from family and friends. Start an exercise program which requires more endurance. Your body will start to recover and your diabetes complication risks will be lowered immediately! Good luck!


NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.

Roberta Kleinman

Roberta Kleinman

Roberta Kleinman, RN, M. Ed., CDE, is a registered nurse and certified diabetes educator. She grew up in Long Island, NY. Her nursing training was done at the University of Vermont where she received a B.S. R.N. Robbie obtained her Master of Education degree, with a specialty in exercise physiology, from Georgia State University in Atlanta, Georgia.

She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.

She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.
Roberta Kleinman

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