Tobacco and diabetes
Diabetes mellitus is a chronic disease affecting multiple systems in the body and often leading to substantial disability due to blindness, vascular disease necessitating leg amputation, kidney failure and premature death. There are two forms of diabetes mellitus, insulin-dependent (IDDM) and non-insulin-dependent (NIDDM).
NIDDM usually is diagnosed in midlife and may be treated with diet modification, drugs and lifestyle modififcation to encourage regular exercise. Studying the effect of smoking on NIDDM is made more difficult by the fact that people who smoke are more likely to be sedentary and overweight which are themselves risk factors for NIDDM. One way to solve this problem is following a group of people over time and identifying people when they are initially diagnosed so that their smoking at time of diagnosis and in the years leading up to diagnosis can be examined.
Among male health care professionals in the US, smoking 25 or more cigarettes daily appears to double the risk of NIDDM 1. This is important because once diagnosed, NIDDM is often more severe in those who continue to smoke.
(1) Rimm EB, Stampfer MJ, Colditz GA, Willett WC. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ 1995; 310:555-9.