Understanding the Overlooked Risk Factor
Smoking is a significant yet often overlooked risk factor for individuals living with diabetes. Despite its severe implications, both patients and healthcare professionals frequently underestimate its impact. Smoking exacerbates complications and is the leading cause of mortality among diabetic patients. In response, the French Federation of Diabetics, the French Society of Diabetes (SFD), and the Francophone Society of Tobacco Science (SFT) have joined forces to combat smoking in this vulnerable population through new initiatives.
The Connection Between Smoking and Diabetes
Is there a direct link between smoking and the onset of diabetes? According to Professor Vincent Durlach, a specialist in metabolic diseases and tobacco science at the University Hospital of Reims, smoking increases the risk of developing type 2 diabetes by 37 to 44%. This statistic holds true even when accounting for other risk factors such as age, diet, genetics, and obesity. The relationship is dose-dependent, meaning the more one smokes, the higher the risk of deteriorating glycemic control, leading to increased insulin levels and eventually diabetes.
Prevalence of Smoking Among Diabetic Patients
Globally, approximately 20.8% of individuals with type 2 diabetes (T2D) and between 10% to 39% of those with type 1 diabetes (T1D) are smokers. In France, updated data from the Entred-3 study reveals that 13.4% of T2D patients and a quarter of T1D patients smoke, equating to 410,000 diabetic smokers. These individuals are typically young, sedentary males with lower socioeconomic status, highlighting a significant public health concern.
Complications Arising from Smoking in Diabetics
Smoking significantly increases the risk of complications in diabetic patients. Professor Bruno Vergès, an endocrinologist and diabetologist at the University Hospital of Dijon, notes that smoking raises the risk of coronary heart disease by 54% and stroke by 44% in diabetic smokers compared to non-smokers. Overall mortality is 48% higher among diabetic smokers, with cardiovascular mortality increased by 36%. T1D patients face heightened risks of vascular complications, including microalbuminuria, end-stage renal disease, and retinopathy.
Additionally, smoking in diabetics is linked to a higher risk of cancers, particularly pancreatic, hepatocellular, and colorectal cancers, as well as an increased risk of infections and depression. Alarmingly, smoking is the leading cause of death among T2D patients, yet it is not addressed with the same urgency as other health metrics like glycemic control or cholesterol levels.
Awareness Among Healthcare Professionals
Despite the clear risks, awareness among healthcare providers is lacking. A survey of 225 diabetologists from the SFD revealed limited knowledge about the diabetogenic effects of smoking. Many healthcare professionals are unaware of the link between smoking and deteriorating glycemic control and are not adequately equipped to support smoking cessation due to time constraints and lack of expertise.
Professor Durlach, who conducted the survey with addiction specialist Professor Ivan Berlin, emphasizes the need for a multidisciplinary approach to smoking cessation, involving medical and paramedical tobacco specialists and general practitioners. Addressing the psychological, social, and relational challenges faced by patients is crucial for successful intervention.
Initiatives to Combat Smoking in Diabetic Patients
In light of these challenges, increasing awareness and support for smoking cessation, particularly among high-risk groups, is imperative. The French Federation of Diabetics has launched a new campaign, supported by the Ministry of Health, to educate patients about the dangers of smoking and assist them in quitting. This initiative targets individuals at risk of T2D and continues to support diabetic smokers through a collaborative effort by the SFD, SFT, and FFD.
The Federation has initiated a pilot program in six departments (Marne, Bas-Rhin, Alpes-Maritimes, Bouches-du-Rhône, Haute-Garonne, Loire-Atlantique) in collaboration with its affiliated associations. This program offers tailored support to diabetic smokers through two group workshops spaced three months apart, followed by a phone call to reinforce motivation and track progress. Co-facilitated by tobacco specialists and patient experts, these workshops provide a supportive environment for smoking cessation.
A Global Health Concern
The World Health Organization (WHO) emphasized in 2023 the importance of addressing smoking as a diabetogenic factor and prioritizing smoking cessation in diabetic patients. The key messages are clear: avoid smoking if at risk of diabetes and prioritize quitting if already a smoker and diabetic. Healthcare providers must focus on these critical interventions to improve patient outcomes.
🔗 **Fuente:** https://francais.medscape.com/voirarticle/3613185