Smoking cessation and risk of type 2 diabetes

Risk of type 2 diabetes mellitus (T2DM) is higher in tobacco smokers compared to non-smokers. The risk declines after smoking cessation. However, ex-smokers are also more prone to the metabolic syndrome. The question thus is, whether ex-smokers could temporarily have a higher risk of T2DM than current smokers. The available studies on this topic are not in agreement in their conclusions, as most of them also primarily do not compare ex-smokers to current smokers, but to non-smokers. However, based on the available studies, it rather seems the risk of T2DM is temporarily higher after smoking cessation. The higher risk of T2DM seems to be enhanced by weight gain that typically occurs first years after smoking cessation without intervention. Therefore, smoking cessation in patients who are in an increased risk of T2DM should be accompanied by T2DM preventative measures (lifestyle modification, weight monitoring and recommendation of pharmacotherapy of tobacco addiction to lower the risk of weight gain) and more frequent checks of blood glucose level to ensure early T2DM detection.