TUESDAY, Nov. 22, 2016 -- While smoking is tough enough on
health, adding in diabetes boosts the risk of an early death even more, new
research confirms.
Heavy smokers
who also have diabetes are at twice the risk of an early death compared to
smokers without the blood sugar disease, the study found.
"Smoking is
bad for all, but even more in those with diabetes," said Dr. Joel
Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center
in New York City. He reviewed the new findings.
The study was
conducted by researchers at the University of Colorado, Denver, and involved
data on more than 53,000 Americans who were either current or former heavy
smokers.
The overall risk
of an early death was roughly double if the smoker had diabetes, the
researchers reported. Overall, almost 13 percent of smokers with diabetes died
during the seven-year study period, compared with just under 7 percent of those
who weren't diabetic.
Women with
diabetes seemed even more vulnerable than men when it came to lung cancer,
specifically.
The study found
that female smokers with diabetes had an 80 percent higher risk of dying from
lung cancer, compared with female smokers who didn't have the illness.
That trend was
not seen among men, however. For males, having diabetes was tied to higher odds
for early death overall, but it did not seem to be linked to higher risk of
dying from lung cancer, specifically, the findings showed.
According to
study lead researcher Dr. Kavita Garg, the findings indicate that "taking
control of diabetes is important among smokers, whether they undergo screening
for lung cancer or not, because diabetes is an independent risk factor for
dying."
Garg is a
professor of radiology at the university. In the study, her team looked at data
from people who took part in the National Lung Screening Trial. That U.S. trial
compared CT chest scans against chest X-rays, to see how each fared as early
screening for lung cancer in current and former heavy smokers.
More than 5,000
of the smokers in the trial (nearly 10 percent) also had diabetes. Participants
with diabetes tended to be older, and to smoke and weigh more than those
without diabetes, the researchers noted.
Garg's team
analyzed the risk of dying from lung cancer, other cancers and from any cause.
Over the seven years of the trial, nearly 4,000 participants died, including
more than 1,000 from lung cancer and more than 800 from other cancers.
Zonszein said
the new findings should come as little surprise.
"We all
know that smoking is not good for patients with diabetes -- it worsens
peripheral artery disease [poor leg circulation] and heart disease, and
predisposes people to an early lung cancer death or disability by chronic
obstructive lung disease [COPD]," he said.
More than 29
million people in the United States have diabetes, according to the U.S.
Centers for Disease Control and Prevention.
Dr. Gerald
Bernstein, an endocrinologist and coordinator of the Friedman Diabetes Program
at Lenox Hill Hospital in New York City, added that "the bigger picture
makes these findings even more ominous."
That's because
even among people with pre-diabetes -- a precursor to diabetes -- "smoking
is as big a risk for dying as high blood pressure and high cholesterol,"
Bernstein said.
Bernstein
concedes that quitting smoking is hard, and takes more effort than just taking
a pill to control blood pressure or cholesterol.
But, another
expert said, battling a smoking habit and diabetes at once can be challenging.
"When
patients are diagnosed with diabetes, quitting smoking does not always seem
like a top priority," said Patricia Folan. She directs the Center for
Tobacco Control at Northwell Health in Great Neck, N.Y.
Patients are
often overwhelmed by the many lifestyle changes required to control their
diabetes, she said.
"Often,
what is not appreciated is the fact that the complications of diabetes -- an
increased risk of heart attack and stroke, damage to blood vessels, kidney
disease, infections, ulcers, amputations and blindness -- are more likely to
occur if you are smoking," Folan explained.
However,
"quitting smoking will improve the overall health of patients with
diabetes and make it easier for them to exercise and control their diabetes
while avoiding the complications of the disease," she added.
The results of
the study were scheduled to be presented Tuesday at a meeting of the
Radiological Society of North America in Chicago. Data presented at medical
meetings should be considered preliminary until published in a peer-reviewed
journal.
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