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Quitting Smoking Can Raise Diabetes Risk

But interventions can keep the illness at bay, experts say

MONDAY, Jan. 4, 2010 (HealthDay News) -- Smokers who give up the habit have an increased risk of developing diabetes over the next few years, a new study finds.

The finding wasn't a surprise, since smokers typically gain weight when they quit, and weight gain is associated with diabetes, noted study author Hsin-Chieh Yeh, an assistant professor of general internal medicine and epidemiology at the Johns Hopkins University School of Medicine in Baltimore.

And the finding should not be used as excuse to keep smoking, Yeh said, since the benefits of not smoking far outweigh the risk seen in the study and there are simple measures to cut the odds for diabetes.

"The main message we would like to convey is that quitting smoking is good," she said. However, "when a person quits, the physician should pay additional attention in terms of weight measurement and counseling."

The study is published in the Jan. 5 issue of the Annals of Internal Medicine.

Yeh and her colleagues studied almost 11,000 middle-aged people who were not diabetic when the study began. Over nine years, 1,254 of them developed type 2 diabetes, in which the body gradually loses the ability to maintain proper levels of blood sugar.

Among the 380 participants who gave up smoking, the incidence of newly developed diabetes was 70 percent higher than among those who never smoked. Continuing smokers also had a greater risk of developing diabetes in that period, 30 percent higher than for nonsmokers.

"The higher risk for smokers who quit was seen for about six years out," Yeh said. "It became attenuated and disappeared after about 10 years."

The increased risk was directly related to the amount of weight gain seen in the former smokers, Yeh said. In the first three years after quitting, the average weight gain for former smokers was 8.4 pounds, with an average 1.25-inch increase in waist circumference.

In addition to paying attention to weight, "we would suggest that physicians seeing former smokers check on glucose levels more frequently as a means of early detection of diabetes," Yeh said.

Of course, it's better to have never smoked at all, since smoking is also an established risk factor for diabetes, said Dr. Richard Bergenstal, executive director of the International Diabetes Center in Minneapolis, and newly appointed president of medicine and science at the American Diabetes Association. He added that for someone who already smokes, "stopping is critically important."

"Someone at risk for diabetes who stops smoking should have blood sugars checked on a regular basis and should have counseling on weight gain," Bergenstal said. "If diabetes is detected, it should be treated in an effective way, according to American Diabetes Association guidelines."

Effective treatment starts with lifestyle measures such as proper diet and physical activity to prevent obesity, with medication if necessary, he said.

"Lets get rid of the known risk factors," including smoking, Bergenstal said. "If blood sugar levels become elevated, we do have treatments for that."

More information

There's more on preventing diabetes at the American Diabetes Association.

SOURCES: Hsin-Chieh Yeh, Ph.D, assistant professor, general internal medicine, epidemiology, Johns Hopkins University School of Medicine, Baltimore; Richard Bergenstal, M.D., exeutive director, International Diabetes Center, Minneapolis, president, medicine and science, American Diabetes Association; Jan 5, 2010, Annals of Internal Medicine
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