The characteristics of type 2 diabetes vary from patient to patient and it has been suggested that the condition consists of four subtypes. Now, the new research presented at the European Union’s annual meeting on the study of diabetes (EASD) in Vienna, Austria (September 15-19) shows that smoking increases the risk of the situation, regardless of the subtraction.
Researchers in Sweden, Norway and Finland have also found that people with genetic sensitivity in diabetes development seem more vulnerable to the adverse effects of smoking.
It has previously been suggested that type 2 diabetes (T2D) can be divided into the following subtypes: sird (severe insulin -resistant diabetes), characterized by insulin resistance (where body cells do not respond properly to insulin and cannot easily receive glucose). Sidd (severe insulin deficiency), characterized by insulin deficiency. Mod (mild diabetes associated with obesity), associated with obesity and the younger age. and Mard (mild age -related diabetes) later developed in life.
The severity, prognosis and the risk of complications differ between subtypes, but it is not clear if they have different risk factors.
To find out more, Emmy Keysendal, a doctoral student at the Karolinska Institutet, Stockholm, Sweden and his colleagues examined the relationship between smoking, which is already known as a powerful risk factor for T2D in general and other forms of use of tobacco and tobacco use.
The researchers used data for 3,325 people with T2D (495 Sidd, 477 Sird, 693 Mod and 1660 Mard) and 3,897 witnesses from a long -term diabetes study in Norway (17 years of monitoring time) and case control study in Sweden.
They found that smokers (current and past smokers) are at higher risk of all four T2D sub-types than those who had never smoked. The relationship between smoking and Sird was particularly strong.
Smokers were more than twice as likely (2.15 times), as smokers never develop Sird. This is compared to the 20% risk increase for SIDD, 29% for MOD and 27% for the Mard.
Smoking is estimated to be responsible for more than one third of SIRD cases, but less than 15% of other diabetes subtypes (SIDD, MOD and MARD).
Smoking heavy (≥15 years of packages/20 cigarettes a day for 15 years or equivalent) further increased the risk of all four subtypes. Heavy smokers were 2.35 times more likely to develop SIRD than ever smokers and 52%, 57% and 45% likely to develop Sidd, Mod and Mard, respectively.
Interestingly, the data for men in Sweden have suggested that heavy use of SNUS, a tobacco -free tobacco product that is popular in the Scandinavian countries, was associated with an increased risk of severe SIDD subtypes (19% higher risk) and sird (13% higher risk).
The study also investigated if smoking further increased the risk in people with genetic predisposition to T2D, insulin resistance or reduced insulin secretion.
This showed that heavy smokers with genetic predisposition to T2D or reduced insulin secretion were particularly vulnerable.
For example, those who smoke heavily and had a high genetic risk for weakened insulin secretion had more than three times the risk (3.52 times) of Sird growth compared to those without these risk factors.
The researchers concluded that smoking increases the risk of T2D, regardless of the subtype.
It is clear that smoking increases the risk of type 2 diabetes, regardless of the subtype, that is, regardless of whether diabetes is characterized by insulin resistance, insulin deficiency, obesity or aging.
The strongest correlation was observed for the subtype characterized by severe resistance to insulin (sird), which suggests that smoking can contribute to diabetes, reducing the body’s ability to respond to insulin.
Our findings emphasize the importance of stopping smoking in the prevention of type 2 diabetes. They also indicate that genetic information can help detect people who are more likely to benefit from additional support for smoking cessation. ”
Ms Emmy Keysendal, a doctoral student at Karolinska Institutet
