Cigarette Smoking: An Accessory to the Development of Insulin Resistance

Insulin resistance is a condition characterized by decreased sensitivity of a skeletal or adipose cell to insulin, resulting in decreased glucose uptake by the cell. This can lead to hyperinsulinemia and further reduce insulin sensitivity. Insulin resistance is one of the primary factors contributing to metabolic syndrome (MetS), causing elevated glucose and fatty acid concentrations in the blood. Smoking is associated with insulin resistance in a dose-dependent manner. It directly increases the risk for insulin resistance, mainly via hormone activation, and may indirectly cause insulin resistance due to its effects on abdominal obesity. Nicotine may be the factor underlying these potential mechanisms. With the prevalence of prediabetes and diabetes on the rise, and considering the role of smoking and its relationship to insulin resistance, smoking reduction or cessation may be a viable option for those who are at risk or already identified as insulin resistant. Therefore, smoking cessation or reduction would serve as a beneficial component in any diabetes prevention or treatment plan.