Smoking and diabetes.

Farid Benzerouk, Alexia Rouland, Anne-Laurence Le Faou, Philippe Thuillier, Thibault Bahougne, Vincent Durlach, Bruno Vergès, Daniel Thomas, Ivan Berlin, Carole Clair, Abdallah Al-Salameh, Blandine Tramunt

Journal: Annales d'endocrinologie 2024;85(6):614-622

PMID: 39218351

Full Text on Elsevier Science View on PubMed

Abstract

Smoking increases insulin resistance via multiple mechanisms but is a poorly understood risk factor for onset of type-2 diabetes. It is also associated with impaired beta-cell function in humans, but again the mechanisms are poorly understood. Mechanistic studies of the impact of smoking on carbohydrate metabolism mainly evaluated nicotine as the causal agent, and more rarely other tobacco constituents, making it impossible to conclude that the risk of diabetes is linked to the effects of nicotine alone. Active smoking also has negative impact on glycemic control in both type-1 and type-2 diabetic patients. It increases the risk of all-cause mortality and worsens the chronic complications of diabetes. Impact on microangiopathic complications in type-2 diabetic patients, however, is more controversial. Data on pharmacological and behavioral strategies for smoking cessation used in the general population are more sparse in diabetic patients, despite opportunities with recent therapeutic trials involving varenicline and GLP-1 analogues. It is essential for diabetic patients to stop smoking, and diabetologists must get involved in smoking cessation as they have done for many years in therapeutic education, which can easily include measures to help patients stop smoking.

Address: Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France.; Department of Endocrinology, Diabetology and Metabolic Diseases, University Hospital of Brest, Brest, France. Electronic address: [email protected].; Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France; PeriTox=UMR-I 01, University of Picardy Jules-Verne, Amiens, France.; Cognition Health and Society Laboratory (C2S-EA 6291), University of Reims Champagne-Ardenne, Reims, France; Department of Psychiatry, Marne Public Mental Health Institute & Reims University Hospital, Reims, France.; Department of Endocrinology and Diabetology, Strasbourg University Hospital, Strasbourg, France; Institute of Cellular and Integrative Neuroscience, CNRS UPR-3212, Strasbourg, France.; Institute of Metabolic and Cardiovascular Diseases, UMR1297 INSERM/UPS, Toulouse University, Toulouse, France; Department of Diabetology, Metabolic Diseases and Nutrition, Toulouse University Hospital, Toulouse, France.; Department of Medical Pharmacology, hôpital Pitie-Salpêtrière-Sorbonne université, AP-HP, Sorbonne, France.; Department of Ambulatory Care, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.; Institute of Cardiology, hôpital Pitie-Salpêtrière, Sorbonne University, Paris, France.; Outpatient Addiction Center, Georges-Pompidou European Hospital, AP-HP Centre-Université Paris Cité, Paris, France.; Department of Endocrinology, Diabetology and Metabolic Diseases, CHU Dijon, Dijon, France; INSERM LNC-UMR1231, University of Burgundy, Dijon, France.; Champagne-Ardenne University, UMR CNRS 7369 MEDyC & Cardio-Thoracic Department, Reims University Hospital, Reims, France.

DOI: 10.1016/j.ando.2024.08.001

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MeSH Terms: Humans, Diabetes Mellitus, Type 2, Smoking, Smoking Cessation, Risk Factors, Insulin Resistance, Diabetes Mellitus, Diabetes Mellitus, Type 1, Nicotine