Smoking increases the harmful effects of diabetes by increasing insulin resistance and worsening diabetes control. It raises the likelihood of microvascular and macrovascular complications associated with diabetes. The risk of death from heart disease and stroke is increased, as are the possibilities of neuropathy, nephropathy, and retinopathy.
At the same time, smokers with diabetes have unique issues in terms of motivating and maintaining cessation. Some studies of smokers with diabetes have found that they tend to be less actively involved in their diabetes care than nonsmokers; for example, they may be less likely to check their blood glucose levels frequently or exercise regularly. They tend to feel less support from family and friends, and they report “often feeling sad or depressed” more often than their nonsmoking counterparts. Post-cessation weight gain may also be an impediment to quitting.
In addition to these challenges, providers caring for persons with diabetes face barriers to providing cessation assistance. Health education for people with diabetes tends to focus on glycemic control, diet control, foot care, and other issues directly related to diabetes. Like other healthcare providers, busy family practice physicians and certified diabetes educators frequently do not have sufficient time or compensation to provide effective cessation counseling.
Source: California Diabetes Program (caldiabetes.org)