Smoking is a modifyable risk factor in the incidence of impaired glucose tolerance and type 2 diabetes, but the data concerning the effect of smoking on the course of type 2 diabetes is limited. In this study, we aimed to investigate a possible relationship between smoking and the need of insulin therapy in patients with type 2 diabetes. 470 patients with type 2 diabetes were assessed for smoking habitus, marital and educational status, duration of diabetes, duration of insulin-naive interval, alcohol consumption, adherence to treatment, body-mass index (BMI) and HbA1c. The nonsmokers both never and former were significantly older than the smokers group. Duration of diabetes was significantly longer in nonsmokers than smokers. Insulin treatment was more often in smokers than nonsmokers. The smokers had significantly higher HbA1c levels than both never- and former-smokers. Never smokers and former smokers had similar HbA1c levels. Duration of diabetes was similar in both groups and insulin-naive interval was significantly shorter in smokers and former smokers than never-smokers. Adherence to treatment was better in smokers than nonsmokers. BMI was significantly higher in nonsmokers than smokers. Alcohol consumption was reported in smokers, but not in nonsmokers. In conclusion, the need for insulin treatment was more frequent and earlier in smokers, which could be explained by hyperglycemia induced by smoking and increased toxicity in the microenvironment of pancreatic islets.
03 - 07 May 2008
European Society of Endocrinology