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Diabetes Metab J
v.36(6); 2012 Dec
Diabetes Metab J. 2012 Dec; 36(6): 399–403.
Published online 2012 Dec 12. doi: 10.4093/dmj.2012.36.6.399
Smoking and Type 2 Diabetes Mellitus
Sang Ah Chang
Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Corresponding author: Sang Ah Chang. Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Paul's Hospital, The Catholic University of Korea College of Medicine, 180 Wangsan-ro, Dongdaemun-gu, Seoul 130-709, Korea. Email: rk.ca.cilohtac@hagnas
Author information ► Copyright and License information ►
Copyright © 2012 Korean Diabetes Association
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article has been cited by other articles in PMC.
Cigarette smoking is a well-known risk factor in many diseases, including various kinds of cancer and cardiovascular disease. Many studies have also reported the unfavorable effects of smoking for diabetes mellitus. Smoking increases the risk of developing diabetes, and aggravates the micro- and macro-vascular complications of diabetes mellitus. Smoking is associated with insulin resistance, inflammation and dyslipidemia, but the exact mechanisms through which smoking influences diabetes mellitus are not clear. However, smoking cessation is one of the important targets for diabetes control and the prevention diabetic complications.
Keywords: Diabetes complications, Diabetes mellitus, Smoking
Smoking is one of the modifiable risk factors for many chronic diseases, such as cardiovascular disease (CVD), cancer, chronic obstructive lung disease, asthma, and diabetes. However, the adverse effects of smoking on diabetes have been generally under recognized. In the guidelines from the Korean Diabetes Association, smoking cessation is recommended as one of the most important steps in preventing the cardiovascular complications of diabetes . Many studies have shown that the adverse effects of smoking on diabetes mellitus are not only diabetic macrovascular complications but the causal nature of its association with diabetes and the progression of diabetic microvascular complications has yet to be explored.
Although smoking is known to decrease body weight, it is associated with central obesity . Smoking also increases inflammation and oxidative stress , to directly damage β-cell function  and to impair endothelial function .
The prevalence of smoking in Korean men is near 50%, which is the highest smoking rate in the Western Pacific region. In addition to obesity, the high prevalence of smoking is one of the major health problems for Korea's public health.
This review is about the various smoking effects on diabetes mellitus, diabetic complications, and diabetic incidence. Understanding the hazardous effects of smoking on diabetes mellitus may lead to more emphasis on smoking prevention and smoking cessation as important strategies in the management of diabetes mellitus.
SMOKING AND DIABETES INCIDENCE
There is much evidence that smoking increases the risk of diabetes. Several cohort