Diabetes and Smoking: How Nicotine Affects Blood Sugar and More

Nicotine is one of the main chemicals in cigarettes, e-cigarettes, and many other tobacco products. It’s a powerful stimulant that affects nearly every organ in the body, and its effects are especially concerning for people living with diabetes or prediabetes. Nicotine can alter the way your body responds to insulin, manages blood sugar, and even repairs damaged tissues; it's not conducive to diabetes care. Here, we'll go over more information on the relationship between diabetes and smoking, and how to find resources to help you quit.

In this article, you’ll learn:

• How nicotine affects blood sugar by raising glucose, increasing insulin resistance, and disrupting hormones.
• Why smoking worsens diabetes complications, including heart disease, nerve damage, kidney disease, vision loss, and poor wound healing.
• People who smoke are 30–40% more likely to develop type 2 diabetes, with risk increasing based on smoking habits.
• How smoking constricts blood vessels, raises blood pressure, and limits circulation, especially to hands and feet.
• Why vaping and e-cigarettes are not safe alternatives for people with diabetes.
• Tips to quit smoking safely, including talking with your healthcare provider, monitoring blood sugar closely, using evidence-based quit aids, building a support system, managing stress, and preparing for triggers.
• How quitting smoking improves blood sugar control, circulation, and long-term health outcomes.

What's the Connection Between Smoking and Diabetes?

While smoking cigarettes or other products that contain nicotine may not seem like something that can affect diabetes, there are several ways in which it contributes to health problems. Here's how nicotine impacts the body:

• Impacts Blood Sugar Levels: Nicotine triggers stress hormones like cortisol and adrenaline, which raise blood glucose. However, it can also lead to hypoglycemia for those who take insulin as their diabetes medication.
• Increases Insulin Resistance: Makes it harder for the body to use insulin effectively, leading to higher and more unstable blood sugar levels.
• Constricts Blood Vessels: Reduces circulation and oxygen flow, especially to the hands and feet, increasing your risk of nerve damage and slow-healing wounds.
• Strains the Heart: Elevates heart rate and blood pressure, putting you at a higher risk of heart disease, stroke, and other cardiovascular complications.
• Increases Inflammation: Promotes oxidative stress and chronic inflammation, which can accelerate complications like neuropathy, retinopathy, and kidney damage.
• Delays Healing: Slower tissue repair makes it harder for the body to recover from cuts, infections, or surgery.
• Disrupts Hormones: Stimulates stress hormones, which can make blood sugar more difficult to control and increase cravings or mood swings.
• Affects Nerve Health: Poor circulation and inflammation can worsen diabetic neuropathy and increase the risk of ulcers and amputations.
• Suppresses Immune Function: Makes it more challenging to fight infections, which can lead to longer recovery times.

Cigarette smoking (along with e-cigarettes and tobacco products) can put anyone at risk of serious health issues and chronic disease. Regardless of age, talk to your doctor about tools to help you stop smoking today.

Can Smoking Cause Type 2 Diabetes?

According to the Centers for Disease Control (CDC), smoking is one cause of type 2 diabetes. According to research, people who smoke cigarettes are 30% to 40% more likely to develop type 2 diabetes than people who don't smoke. Moreover, the more cigarettes you smoke, the higher your risk becomes.

The people who are most at risk include:

• People who smoke a pack or more per day
• Those with a family history of diabetes
• Individuals who are overweight or sedentary
• Women who smoke during pregnancy have a higher risk of gestational diabetes

Therefore, one of the best tools to decrease your risk of developing diabetes is to quit as soon as possible. However, this can be challenging, especially if you've been a smoker for several years. Don't hesitate to talk to your doctor to understand your options better and find the help you need.

The Dangers of Smoking with Diabetes

While smoking can increase your risk of developing type 2 diabetes, it also contributes to a higher degree of diabetes-related complications and serious health problems. People with diabetes who smoke tend to have a harder time managing the condition, regardless of whether it's type 1 diabetes, type 2 diabetes, or any other form. Smoking is also a risk factor for the following conditions.

High Blood Pressure

Nicotine and other chemicals in cigarettes cause blood vessels to constrict, making it harder for blood to circulate. This leads to elevated blood pressure, which, over time, damages the arteries and puts extra stress on the heart.

Cardiovascular Disease

People with diabetes already face an elevated risk of heart disease and stroke. Smoking increases that risk even more, as it narrows blood vessels and increases blood pressure, which reduces oxygen flow to the heart. Over time, this significantly increases the likelihood of heart attacks, stroke, and peripheral artery disease (PAD).

Nerve Damage

Smoking limits blood flow to the nerves, depriving them of oxygen and essential nutrients. This can accelerate nerve damage, leading to pain, numbness, tingling, or loss of sensation, especially in the hands and feet. When combined with high blood sugar levels, smoking can make nerve damage more severe.

Kidney Damage

The kidneys work hard to filter waste from the blood, but smoking makes that job more difficult. It increases blood pressure and causes inflammation, which strains the filtration systems and speeds up the progression of damage. Over time, this can lead to chronic kidney disease (CKD) or even kidney failure.

Vision Loss or Blindness

Smoking damages the tiny blood vessels in the eyes, which can worsen diabetic retinopathy, a common cause of vision problems in people with diabetes. Reduced circulation and increased inflammation also raise the risk of cataracts, glaucoma, and permanent vision loss if not properly managed. You can learn more about diabetes and eye health here.

Poor Wound Healing and Amputation Risk

Smoking increases the risk of poor wound healing and even amputation, as nicotine restricts blood flow and lowers oxygen delivery to the extremities. This slows wound healing, especially in the feet and legs. Combined with nerve damage and infection risk, slow healing increases the likelihood of foot ulcers and, in severe cases, amputation.

Is Vaping or Using E-Cigarettes Safer for People with Diabetes?

Many people turn to vaping or e-cigarettes as a way to quit smoking or reduce their exposure to traditional tobacco. While e-cigarettes don’t contain all the harmful chemicals found in regular cigarettes, they’re not a safe alternative, especially for people managing diabetes. Most e-cigarettes still contain nicotine, which is the primary culprit behind many of smoking’s harmful effects.

Even nicotine-free vaping liquids may contain chemicals and flavoring agents that can cause inflammation and oxidative stress, both of which are linked to diabetes-related complications. Some studies suggest that vaping may also impact the immune system, making it more difficult for the body to heal wounds and fight infections.

Finally, while vaping might seem like a "healthier" option, the long-term effects on the body are still not fully understood. Therefore, it's best to use a more evidence-based smoking cessation method, such as:

• Nicotine replacement therapy (NRT) under medical supervision
• Prescription medications that help reduce cravings
• Behavioral counseling or support programs tailored for people with diabetes

Tips to Help You Quit Smoking Safely

Smoking cessation helps improve blood sugar control almost immediately, and the longer you avoid nicotine, the more your body begins to recover. Within days of quitting, your circulation improves, it's easier to manage or control your blood sugar, and your risk of serious health complications starts to decrease. However, since smoking affects blood sugar and stress hormones, it's important to talk to your doctor or diabetes team about how to quit safely. Here are a few tips to get you started.

1. Talk to Your Healthcare Provider

Before making any changes, schedule a visit with your doctor or diabetes care team. They can help you create a personalized quitting plan and adjust your diabetes medications if needed. Nicotine withdrawal can temporarily affect blood sugar, so having professional guidance ensures you stay balanced during the transition.

2. Monitor Your Blood Sugar More Often

When you stop smoking, your body starts to regain sensitivity to insulin, which may cause blood sugar fluctuations. Regular monitoring helps you catch these changes early and make any necessary adjustments. Your doctor can give you a better understanding of how often you'll need to check your blood sugar levels.

3. Use Evidence-Based Quit Aids

Nicotine replacement products, such as patches, gum, lozenges, or prescription medications, can ease withdrawal symptoms and cravings, but they shouldn't be used as a long-term alternative. Ask your provider which options are safe for you and how to use them properly.

4. Build a Support System

Quitting is easier when you’re not doing it alone. Tell your friends, family, and coworkers about your plan, and consider joining a support group or smoking cessation program. Many diabetes education programs offer resources that focus specifically on managing stress and cravings while maintaining stable blood sugar.

5. Manage Stress in Healthy Ways

Nicotine withdrawal can increase stress and irritability, which may trigger cravings. Instead of smoking, try stress-relieving activities like deep breathing, yoga, walking, or journaling. Staying physically active can also help regulate blood sugar and improve your mood.

6. Prepare for Triggers

Identify when and why you tend to smoke and come up with healthier substitutes. Chew sugar-free gum, sip water, or step outside for a few deep breaths instead.

7. Celebrate Small Wins

Every smoke-free day is a victory, so reward yourself for milestones with something meaningful. Recognizing your progress helps keep motivation high and reminds you of how far you’ve come.

To help you manage your diabetes, order your diabetes supplies through Byram Healthcare or contact Byram’s Diabetes Helpline: 1-877-902-9726, ext. 43397, today.