Smoking and the risk of type 2 diabetes

  • Judith Maddatu
    Department of Medicine, Indiana University School of Medicine, Indianapolis, Ind
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  • Emily Anderson-Baucum
    Indiana Biosciences Research Institute, Indianapolis, Ind
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  • Carmella Evans-Molina
    Reprint requests: Carmella Evans-Molina, Indiana University School of Medicine, 635 Barnhill Drive MS 2031A, Indianapolis, IN
    Department of Medicine, Indiana University School of Medicine, Indianapolis, Ind

    Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind

    Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Ind

    Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, Ind

    Roudebush VA Medical Center, Indianapolis, Ind
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Published:March 05, 2017DOI:
      Despite accumulating evidence demonstrating strong epidemiologic and mechanistic associations between cigarette smoking, hyperglycemia, and the development of type 2 diabetes, tobacco abuse has not been uniformly recognized as a modifiable risk factor in diabetes prevention or screening strategies. In this review, we highlight population-based studies that have linked cigarette smoking with an increased risk of type 2 diabetes and summarize clinical and preclinical studies offering insight into mechanisms through which cigarette smoking and nicotine exposure impact body composition, insulin sensitivity, and pancreatic β cell function. Key questions for future studies are identified and strategies for smoking cessation as a means to decrease diabetes risk are discussed.


      AMPKα2 (AMP-activated protein kinase α2), CT (computerized tomography), CI (confidence interval), EPIC-Norfolk (European Investigation into Cancer), HbA1c (higher hemoglobin A1c), HOMA-β (homeostatic model assessment method), MKP1 (MAP kinase phosphatase-1), NGCs (nicotine gum chewers), NAFLD (non-alcoholic fatty liver disease), PPAR-γ (peroxisome proliferator-activated receptor-gamma), PCWG (post-cessation weight gain), snus (smokeless tobacco), T2D (type 2 diabetes)
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