Correlation Between Diverse Smoking Habits and the Risk of Developing Type 2 Diabetes: A Comparative Analysis

Diabetes mellitus (DM) is a prevalent metabolic illness that arises as a result of a complex interplay between genetic predisposition, environmental influences, and lifestyle choices. The precise mechanisms elucidating the association between smoking and the onset of DM remain incompletely understood, despite the proposal of several ideas. The objective of this study ‎was to conduct a comparative analysis of blood glucose levels, hemoglobin A1c (HbA1c) levels, insulin hormone levels, and homeostasis model assessment of insulin resistance (HOMA-IR) ‎levels in diabetic patients who smoked and those who did not.

The study included a total of 320 volunteers divided into four groups, with each group consisting of 80 volunteers. The first group served as the control group and consisted of ‎healthy individuals. The remaining three groups consisted of type 2 diabetes mellitus (T2DM) patients, categorized based on their smoking habits. The second ‎group comprised T2DM patients who did not smoke, the third group consisted of T2‎DM patients who smoked cigarettes, and the fourth group included T2DM patients ‎who smoked e-cigarettes.‎ At recruitment, data on age, fat %, waist circumference (cm), and body mass index (kg/m²) was collected. Biochemical markers measured were fasting blood glucose (FBG), HbA1c, insulin, and HOMA-IR‎ levels.

The findings demonstrated a statistically significant increase (P<0.001) in the levels of each parameter, particularly among patients with T2DM who engaged in e-cigarette smoking, compared to the control group.‎ It was found that engaging in dual smoking, which involves the use of both traditional cigarettes and e-cigarettes, was associated with a higher likelihood of elevated HbA1c levels and other negative health effects.

When it comes to the management of diabetic patients, abstaining from smoking and participating in smoking cessation programs, for patients who smoke, should be the essential approaches. It was found that dual smoking led to a higher likelihood of elevated HbA1c levels and this association was most pronounced among male individuals, those who were physically inactive, and those classified as obese. Further studies should be conducted on the detrimental health consequences associated with e-cigarettes, with a particular focus on enhancing the awareness of healthcare professionals and their patients of the potential risks. This is particularly significant due to the prevailing perception that e-cigarettes are inherently "safe".