Tobacco use exacerbates diabetes5/11/2010
For years, Guam residents, and Pacific Islanders in general, have been told their genetic predispositions and heavy diets make them prime candidates for developing Type II, or adult-onset, diabetes.

Through exercise and eating healthy, diabetes can be kept at bay.

Wellness Works will get to diet in the coming weeks, but on your part, doctors, researchers and health educators say there's one thing you can do immediately to prevent the risk of getting diabetes, and if you already have it, a way to reduce your chances of being hit with the serious complications that ensue from the disease: Quit smoking.

According to the International Diabetes Federation, when diabetes is already present, smoking increases the incidence, mortality and morbidity from cardiovascular complications, diabetic foot problems, diabetic eye disease and diabetic kidney disease.

"By having high-risk behaviors ... the possibility of having the conversion from becoming pre-diabetic to diabetic is higher when a person doesn't take care of themselves by not eating healthy, by smoking, by not exercising," added Eugene Santos, a health education administrator at the Department of Public Health and Social Services.

"The use of tobacco, in diabetes, contributes to the reduction in circulation in the body and those are things that are tied in," Santos said.

Since diabetes is caused by the failure or impairment of the pancreas to release enough insulin to break down glucose, the reduction in circulation caused by smoking hinders the ability for glucose to be absorbed quickly enough by the cells, Santos explained.

"It stays within the body and bloodstream, and it's not being removed," he said.

On Guam, about 27.4 percent of people are smokers, and about 7.9 percent of people have diabetes, Santos said citing 2008 figures.

"For those who have diabetes, the risk of cardiovascular disease can be 14 times the risk from either smoking or diabetes by itself," Santos said. "People who have diabetes and smoke are three times more likely to die of cardiovascular disease than are other people with diabetes."

Plus, smoking reduces the amount of oxygen going to the organs that release insulin to control those glucose levels.

"Tobacco smoke cuts down on the amount of oxygen that reaches your different organs like the kidney or the heart," said Dr. Annette David, the senior partner for consulting services for Health Partners LLC. Smoking increases blood pressure, while slowing down "blood flow," the amount of oxygen that reaches the organs, said David, who is also a Public Health consultant for tobacco cessation.
"You're setting up the stage for heart attack," she said. "That, on top of the effects of diabetes in terms of clogging up your arteries, it serves as a double-whammy."
In 2003, the federation released an official "position statement" regarding the link between diabetes and smoking, declaring tobacco as harmful to health and of particular danger to people with diabetes.
"Smoking cessation has immediate positive effects; however, it is made difficult by tobacco dependence and by all forms of advertising and promotion used by the tobacco industry," the federation's website reads.
The federation then urged diabetic tobacco users to quit smoking, and encouraged diabetes management and educational programs to include smoking cessation and discussions of the dangers of smoking into their programs.
However, according to David, a recent local survey of 125 patients -- the results of which will be published in the Hawaiian Medical Journal in June -- showed 38 percent of current tobacco users on Guam who were diabetic never received this advice from their physicians.
"That means that there's a gap in our primary care," David said.
Conflicting reports
Smokers probably gave a sigh of relief when they heard earlier this year that a study showed quitting smoking can actually increase your chances of getting diabetes.
Reuters, the BBC, and The Guardian newspaper reported in January that people who stop smoking have a 70 percent increased risk of developing Type-II diabetes in the first six years without cigarettes.
However, a closer look at that study showed their "increased risk" was compared to people who never smoked.
The scientists involved in the study said they believed the short-term increase in chance in developing diabetes was caused by weight gain associated with quitting smoking, according to the Reuters report, and that's where diet and exercise come in to play.
The message was clear:
"Don't even start to smoke," Reuters quoted Hsin-Chieh Yeh of the Johns Hopkins University School of Medicine saying. "If you smoke, give it up. That's the right thing to do. But people have to also watch their weight."


Source:
Guampdn.com http://www.guampdn.com/article/20100510/NEWS01/5100306