Diabetes and Cigarettes: A Troublesome Twosome

It's a well-known fact that people with diabetes have a higher-than-average risk of cardiovascular disease. But when you add cigarettes to the equation, the picture gets considerably grimmer.

"We think of diabetes as a disease of glucose metabolism but in fact it's a vascular disease, especially type 2," says Dr. Patricia Solber, chief medical officer at Universal American, a senior-focused health care company. People with diabetes can have serious trouble with their blood vessels, which often contain artery-clogging plaque that lead to strokes and heart attacks, she says.

"Now when you factor in smoking, which contributes to vascular disease and early heart attacks, you have really created a double whammy that puts people with diabetes at greater risk," Solber says.

 Reducing your chances of having a heart attack or a stroke starts with four crucial steps, according to the American Diabetes Association Position Statement "Standards of Medical Care in Diabetes 2008." The steps are: Take aspirin, control your lipids, control your blood pressure and stop smoking. Smoking can be the tallest order for many, but it is a crucial step to heed.

"Cigarettes and diabetes speeds the artery clogging process," says Dr. Blanca Sckell, internist at Saint Vincent's Hospital in New York City. "When you have diabetes and you smoke, your arteries harden four times faster and you are four times as likely to have a heart attack than if you didn't smoke. You can have a heart attack sooner and faster."

"Smoking when you have diabetes is like adding fuel to the fire," says Kellie Rodriguez, a certified diabetes educator at the Diabetes Research Institute at the University of Miami.

Quitting, of course, can be a real challenge, she adds. "Most of the people who succeed are those who really think it is important," Rodriguez says.

Most of the evidence on people who succeed at quitting shows that a quit-smoking program plus medication works best, Solber says. "Most health insurance companies will cover the medications but if you also have the opportunity to take a quit-smoking program, it is really recommended," she says.

What else you can do to succeed as a quitter:

  • See if there's a clinical trial going on in your area that includes help with quitting smoking as one of the interventions, recommends the American Diabetes Association.

  • Stop thinking of smoking as just a habit, advises the American Diabetes Association. Begin to think of it as a medical problem instead.

  • Don't give up if you break down and have a butt.  Many people quit three or four times before being able to throw away their cigarettes for good, according to the American Diabetes Association.