I can summarize this little article in one quick sentence: Smoking is bad. In the general population, and particularly for people with diabetes.... Smoking is bad. Cigarette smoking is the leading cause of avoidable death in the United States, and accounts for almost 500,000 deaths a year. Smoking plays a role in one out of every five deaths in the United States per year. The statistics are even worse for people with diabetes. There is an increased risk of premature death and the development of heart disease in patients who have diabetes and continue to smoke. There is also evidence that links cigarette smoking with microvascular disease (kidney and eye damage) in diabetes. Additionally, there is data that shows that smoking may actually play a role in the development of type 2 diabetes. As a doctor, I think it is extremely important to encourage patients who have diabetes to stop smoking, and certainly not to start this habit.
The American Diabetes Association has developed guidelines for health care providers to help them deal with patients with diabetes who smoke. Your doctor should provide:
- A systematic assessment of your smoking history
- Counseling on smoking prevention and cessation
- Assessment of willingness to quit smoking at each visit
- Training on how to use smoking cessation systems
- Follow-up to assess and promote quitting
Most health care provider agree that encouraging people to stop smoking can be frustrating at times. To do it properly, health care providers must sometimes nag, remind, and employ various tactics ranging from rationalization (“you know smoking is bad for you, don’t you?”) to blatant fear (“smoking is clogging up your arteries as we speak”). With diabetes and smoking, 1 plus 1 does not equal 2, but rather 4. The risks for heart disease increase exponentially. Don’t be afraid to approach your health care provider for information on quitting and any available resources and/or medications. Your physician is not going to judge you by whether you succeed in quitting or question your motivation for waiting until this particular time to try.
WEIGHT GAIN
Although not everyone who quits smoking is destined to tip the scales with a few extra pounds, a recent nationwide survey of 5,000 adults suggests that those who do quit are likely to gain about 10 pounds. One reason is that once you stop smoking, your metabolic rate slows down because your body no longer has to metabolize all the toxic substances cigarettes contain. So, you burn fewer calories. As taste buds recover, foods begin to taste better you unconsciously may be eating more than you realize. Furthermore, you may eat more to compensate for the loss of oral stimulation smoking provides and to counter the anxiety nicotine withdrawal causes. But health experts agree that this small weight gain is no reason to keep puffing cigarettes. Try some of these strategies to help keep your weight in check:
- Increase your physical activity.
- Strive to increase the amount of vegetables, fruits, and whole grains in your diet.
- Eat breakfast. Many smokers skip this meal, since what they want in the morning is a cigarette, not food.
- Find new ways to get an “oral fix.” Try chewing gum or sucking on hard candy (both sugar-free, of course), or crunch on a carrot or celery stalk.
