Hypertension and Cardiovascular Rehabilitation Unit, Faculty of Medicine, University of Leuven K.U.Leuven, Leuven, Belgium.
Prim Care Diabetes. 2009 Nov;3(4):205-9. doi: 10.1016/j.pcd.2009.09.003. Epub 2009 Oct 28.
Smoking is a predictor of the transition from normoglycaemia to impaired fasting glucose and increases the risk of type 2 diabetes, independent from possible confounders. In patients with diabetes as in non-diabetics, smoking is a significant and independent risk factor for all-cause mortality and for mortality from cardiovascular disease and corononary heart disease, as well as for aggregates of fatal and non-fatal cardiovascular events. There is little doubt that smoking is a risk factor for coronary heart disease, but this risk appears to be stronger than the risk for stroke in diabetics. Pathophysiological mechanisms by which smoking causes glucose intolerance and worsens clinical outcomes in established diabetes include greater insulin resistance, impaired beta-cell function and insulin secretion, chronic low-grade inflammation, endothelial dysfunction, as well as interacting indirectly with other factors known to aggravate diabetes and lifestyle factors. Smoking cessation programs are of great importance for primary care specialists dealing with diabetes.
吸烟是从正常血糖向空腹血糖受损转变的预测因子，并增加 2 型糖尿病的风险，独立于可能的混杂因素。在糖尿病患者和非糖尿病患者中，吸烟是全因死亡率以及心血管疾病和冠心病死亡率的重要且独立的危险因素，也是致命和非致命心血管事件的综合危险因素。毫无疑问，吸烟是冠心病的一个危险因素，但这种风险似乎比糖尿病患者中风的风险更强。吸烟导致葡萄糖耐量受损并使已确诊糖尿病患者的临床结局恶化的病理生理机制包括更大的胰岛素抵抗、β细胞功能和胰岛素分泌受损、慢性低度炎症、内皮功能障碍，以及与其他已知加重糖尿病和生活方式因素的因素间接相互作用。戒烟计划对于处理糖尿病的初级保健专家非常重要。
