Chandni
Smoking is an independent risk factor for all-cause mortality, due largely to cardiovascular disease.
There is a dose-response relationship between current smoking status and risk of coronary disease in women with diabetes. The risk is 1.7 and 2.68 for 1 to 14 and >15 cigarettes per day, respectively. The risk returns to baseline in those who had stopped smoking for more than 10 years.
The risk of mortality in diabetic women also increases with the number of cigarettes smoked per day. The risk is 1.4 and 2.1 for 1-14 and >35 cigarettes/day, respectively. The risk decreases substantially 10 years after quitting smoking (risk 1.1)
Smoking is associated with increases in the serum concentrations of total cholesterol and very-low-density lipoprotein cholesterol, a decrease in serum high-density-lipoprotein cholesterol concentrations, and a greater degree of insulin resistance. Smokers, via an uncertain mechanism, have poorer glycemic control.
In patients with type 1 diabetes, smoking is independently associated with an increase in urinary albumin excretion and nonproliferative retinopathy; the degree of albuminuria falls to the level of nonsmokers if smoking is discontinued.
Smokers with either type 1 or type 2 diabetes are at increased risk for neuropathy, an effect that persists after adjusting for glycemic control. Smoking is associated with an increased risk of end-stage renal disease and with decreased survival once dialysis is commenced.
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