Type 2 diabetes, characterized by insulin resistance and/or abnormal insulin secretion and increased glucose production, continues to expand unabated throughout the world. The development of new diabetes can be attributed // to decreased physical activity, decreased functional capacity, increased body mass index, preexisting glucose and insulin abnormalities, advanced age and heredity.

Both diabetes and smoking are well-recognized major risk factors for accelerated atherosclerosis and coronary artery disease. However, the possible contribution of cigarette smoking to development of type 2 diabetes has not been specifically investigated.

A recent study published in the October issue International Journal of Cardiology was aimed to evaluate the association between cigarette smoking and development of type 2 diabetes in patients with coronary artery disease and decreased functional capacity over a 6.2-year follow-up period.

The subjects comprised of 630 nondiabetic patients aged 45–74 years, with a fasting blood glucose of <126 mg/dl and with impaired functional capacity. The subjects were classified into two groups: non smokers and smokers. Smokers were younger but they had a relatively unfavorable lipid profile. No significant differences between the groups were found for weight, body mass index, total cholesterol and blood pressure. During the follow-up, development of new diabetes was recorded in 98 patients: in 80 (14.5%) non smokers and in 18 (23.1%) smokers.

The results of this study, conducted in Israel, indicate the current smoking is associated with an independent two-fold increased risk for development of type 2 diabetes in patients with impaired functional capacity.

This, and other such studies conducted, suggests that the majority of cases of type 2 diabetes could be prevented by weight loss, regular exercise, modification of diet, abstinence from smoking, and the consumption of limited amounts of a
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