Smoking and Diabetes

[sc0]

Doing a little speculative Googling earlier on to try to find out a little more about my Humulin-I (Isophane) insulin, I happened across a few interesting articles i found helpful.

Here's the article I started with, on the general effects of smoking and also the more specific effects in diabetics.

http://www.diabetes.ca/Section_About/smoking.asp

Among other things it said that smoking inhibits the body's ability to absorb insulin efficiently. Following on from the recent "Consistently high in the morning" thread, I wondered if the fact that I seem to smoke more later in the evening, and during my late-night interneting than at any other time, was contributing to my general high BG in the morning. More importantly, to what extent this effect actually was.

http://www.d4pro.com/IDM/site/chronic.htm

This was a small study with only a few test subjects and the style is a bit technical, but it's punctuated with little "moments of clarity". Figure 2, for example suggests that there is a direct and frighteningly significant correlation between the number of cigarettes I smoke and the degree of insulin-resistance I'll experience. I would be interested to know about any other reliable sources of info people can recommend on this.

Another thing I found interesting was the fact that there's evidence to suggest that insulin resistance was exhibited to a certain degree in non-diabetic chronic smokers as well - I haven't seen any article that directly accuses smoking of being a contributing factor to the onset of diabetes, but I'm a "where there's smoke, there's fire" kind of man.

Things I'm taking from this so far:

1) Long-term smoking to any great degree can significantly degrade my body's ability to absorb insulin in general.
2) Periods of heavy-smoking can have a directly proportional effect on my insulin uptake, so if a smoke a lot one night say, I can expect that less insulin will have been absorbed and so my BG will probably be higher than my dosages expected effect. This is probably a major reason (perhaps among others) why I've had so much variance in my Basal night insulin effect.
3) When I next try to quit smoking, I will have to take into account that my insulin dosage may have to be reduced to take account of any observed improvement in my insulin absorbtion rate - presumably this would mean that my Basal ratio will change slightly?

I'm thinking out loud, so sorry for the ramble. I guess I'm just wondering if anyone else on here smokes, perhaps wrestling with trying to quit, or having problems with "dawn phenomena" that could perhaps be down to evening/night-time smoking. Anyone covered this with a doc recently?

sc0.

[MarkMunday]

I wasn't aware that smoking increases insulin resistance. That second article is particlularly interesting to me as Larry Distiller was my endocrinologist before I left Johennesburg in 1998. Larry has always been vehemently anti-smoking and refuses to treat diabetics who smoke. He is a fantastic doctor. And I told him that I didn't smoke, even when was still smoking, just so that he wouldn't kick me out of his surgery.

I was diagnosed with T1 at the age of 21. I cut back on the smoking, but didn't give it up until I was 35 (I am now 48). I have always had a big problem with Dawn Phenomenon blood sugar surges. And stopping smoking didn't seem to make any difference. If anything, the DP effect has become more severe since I stopped smoking.

Having said that, the sooner you give up smoking, the better. I know it is difficult. But after you have quit, you won't look back. I now find it hard to believe that I could have willingly engaged in such an anti-social and self-destructive activity. And that I did it for so long!

I cut my smoking in half by making a policy that I didn't smoke at work. I found sticking to that challenging at first. But I soon became used to it. Because I didn't take cigarettes to work with me, I didn't feel tempted. And not having a cigarette for more than 12 hours after waking up in the morning, enabled me to break that addiction.

Sorry if this sounds like a lecture. You really don't need me to tell you what is in you best interests. And best of luck with your endeavours!

Cheers,

Mark

[KrisinNM]

I am a type I and I smoked until Dec 03. No insulin resistence then or now, in fact I am very insulin sensitive. Your point #3 about lowering your insulin when (not IF!) you quit, don't do it until you know for sure how no cigarretes is going to affect you. Quitting changes your metabolism.

[sc0]

Thanks guys. No I don't feel I'm being lectured - if anything I could probably do with more lecturing rather than less.

The risks (I'm a realist - I prefer to think of them as inevitabilities rather than "risks") of smoking are well-documented, but as ex-smokers yourselves you understand the difficulty in quitting. It's not like I really need any more incentive to quit - type I diabetes, father has glaucoma, 8 year old in the house; the list goes on. I just wondered if smoking was having a direct effect on my insulin absorption rate.

It goes without saying that I should quit, and I will. I have to. The tip about not smoking at work is a good one. I stopped for 3 months at one point and the catalyst was not smoking till the evening. I got organised and ready to get up, shower, run out the door for a bus and miss out the morning puff entirely. Once at work, as long as I was busy I didn't go out for smoke breaks. I also have to walk up and down a big hill to and from work as well, so I was getting some light cardiovascular work as well. I also found that those neato lil packets of pre-sliced fresh apple out of Sainsbury's were really effective "do something other than smoke you mindless fidget you" aids.

sc0

[KrisinNM]

scO, after many tries at quitting, the thing that got me stopped was when I had the flu a year ago Dec. It turned into pneumonia, couldn't get to doctor or hospital due to roads closed by avalanches so just had to tuff it out. My chest was so full that I couldn't say more than two words without stopping to gasp. Walking more than a few feet was out of the question. All this brought back memories of my dad near the end of his life- he had enphysema. All I could think was that I didn't want to end up like him or be tied to an oxygen tank the rest of my life.
You can do it if the right motivation is there.

[docta-docta]

Smoking also increases the chance for diabetic neuropathy due to the extended damage to small blood capillaries.

The pain isn't worth smoking, even with the new anti-neuropathy drug that just came to market.

Imagine walking around feeling like your hands and feet have fallen sleep, 24 hours a day. Fun! :thumbsup: :thumbsup: :thumbsup:

[scb]

I've smoked on and off for years, but taken a new years resolution to give up that has so far not failed.
I really noticed what I assume are symptoms of neuropathy. I just felt the veins in my ankles and feet hurt. This was only when I smoked. On giving up my feet have been absolutely fine.
I sympathise, I think as smokers with diabetes we should need our heads examined for even thinking about a cigarette, but I think that we are so required to take into consideration every single thing we do with our bodies that it is only human to now and again just throw it all to the wind. Some will devour a chocolate cake, some will light up, we're only human.

[Mosby]

Late reply but I am new here. I had smoked for 20 odd years. Stopped 1.5 years ago. The leg pains I use to get stopped within 2 months. Have not had any since then.

[Stazza]

Thanks for sharing the information about smoking and nueropathy pain. I recently developed neuropathy in my feet and am still having problems with the pain. I had quit smoking at the beginning of the year but have had an occasional cigarette now and then. I didn't realize that this could be increasing my pain - will definitely throw out the cigarettes!

[Super-D]

I quit smoking for two years but started up again after changing jobs almost a year ago. I constantly struggle with the idea of quiting; I really want to. But, I am a weak, weak person and give in to the temptation.

I developed neuropathy in my legs and feet after I quit smoking. It's pretty severe. I take enough Neurontin to knock out an elephant. I know that my smoking causes me a lot of trouble, and my plan is to stop soon. Don't know when, but soon.

Super-D

[Barb]

Gosh I would love to stop smoking I did many years ago..lasted six months..went out with friends a car full of smokers thats all it took I started up again..I now have been smoking out side DH is not a smoker..I have cut way down now a pack lasts me three days.
it's not an east habit to stop...i also worry about gaining weight...I have 5 more pounds and I will be at my goal weight....
stress right now if rising BS has me wanting those extra smokes but I am trying....

[Mosby]

Barb, I actually lost weight when I stopped. Might be due to haveing to watch what we eat anyway. Remember most folks that put the weight do not have to deal with diabetis and just pig out while we on the other hand can not.

Best of luck to those that try.

[Barb]

Mosby...I agree most of my friends that did stop did not need watching what they ate and ate everything in sight..I tell ya it's mighty cold up here and going out for a smoke in the early Am and PM is a good thing..not out that often and not out that long so I have cut way down

[sparkle9]

I've been type 1 for 34 years (since age 21) and smoked on and off for most of that time. Usually I did not smoke more than 10 cigarettes a day. In October of 2004 I quit smoking. Two months later I was diagnosed with a blockage in one of my coronary arteries. I was shocked! My weight has always been normal, I have always exercised, and my cholesterol was not high. I have no other major diabetes complications. When my cardiologist asked if I smoked and I told him I had off and on for years, he said "Well, what did you expect? Diabetics are at high risk for heart disease and smoking makes it so much worse."

I was "stented" and have been fine so far. My recent nuclear stress test was normal. Sometimes I beat myself up for ever having smoked, but most of the time I'm just glad that I was able to stop. When I saw my cardiologist after the stress test he said "You have done the best thing you possibly could have done for your health."

Enough said. I just hope that reading about my experience might encourage others to quit.