Does smoking worsen insulin resistance?

Smoking is definitely making things worse for people with diabetes. A large number of studies have confirmed that smoking can lead to insulin resistance and accelerate the development of macrovascular and microvascular complications of diabetes. It is one of the main causes of premature death in patients with diabetes.

Although plasma glucose concentrations were similar in long-term smokers and non-smokers, serum insulin concentrations were significantly elevated in long-term smokers. Possible reasons include:

Smoking may impair early action steps such as insulin signaling, glucose transport, and glucose phosphorylation, or impair other biochemical pathways that initiate glucose metabolism at the same time, resulting in decreased insulin sensitivity and insulin resistance.

In addition, long-term smoking can cause increased activity of the sympathetic nervous system, leading to an increase in the release of catecholamines and other glycemic hormones, and an increase in circulating catecholamine levels. Catecholamines are powerful antagonists of insulin action, and catecholamines at the cellular level impair insulin signaling/ Transmission pathways and intrinsic activity reduce the synthesis of glucose transporters, thereby weakening the effect of insulin.

Long-term smokers will weaken the effect of insulin and develop insulin resistance. Therefore, diabetics must quit smoking!