Smoking increases the risk of type 2 diabetes by causing inflammation and oxidative stress in the body. Smokers are 30-40% more likely to develop type 2 diabetes than nonsmokers. Smoking also makes diabetes harder to control and increases the risk of serious health complications like heart disease, kidney disease, and eye problems. Quitting smoking can help prevent and manage diabetes.

2. Diabetes is a disease that causes blood sugar levels in the body
to be too
high and puts the body at risk for many serious health
conditions.

3. HOW SMOKING CAUSES TYPE 2
DIABETES
 Smoking increases inflammation in the body. Inflammation
occurs when chemicals in cigarette smoke injure cells,
causing swelling and interfering with proper cell function.
Smoking also causes oxidative stress, a condition that occurs
as chemicals from cigarette smoke combine with oxygen in
the body. This causes damage to cells.
Evidence strongly suggests that both inflammation and
oxidative stress may be related to an increased risk of
diabetes.

4. HOW IS SMOKING RELATED TO
DIABETES
 We now know that smoking causes type 2 diabetes. In fact,
smokers are 30–40% more likely to develop type 2 diabetes
than nonsmokers. And people with diabetes who smoke are
more likely than nonsmokers to have trouble with insulin
dosing and with controlling their disease.3
 The more cigarettes you smoke, the higher your risk for type 2
diabetes. No matter what type of diabetes you have, smoking
makes your diabetes harder to control.

5.  If you have diabetes and you smoke, you are more likely to have
serious health problems from diabetes. Smokers with diabetes have
higher risks for serious complications, including:
 Heart and kidney disease
 Poor blood flow in the legs and feet that can lead to infections,
ulcers, and possible amputation (removal of a body part by surgery,
such as toes or feet)
 Retinopathy (an eye disease that can cause blindness)
 Peripheral neuropathy (damaged nerves to the arms and legs that
causes numbness, pain, weakness, and poor coordination)

6. prevention
 Don’t smoke. Smoking increases your chance of having type 2
diabetes.
 Lose weight if you are overweight or obese.
 Stay active. Physical activity can prevent or delay type 2
diabetes in adults who are at high risk for the disease

7.  Diabetes treatment and management can include:7
 A healthy diet and physical activity program
 Weight loss (if overweight or obese)
 Medicines to control blood sugar by helping the body use
insulin better
 Insulin taken by injections or by using an insulin pump
 Patient education to address problem-solving and coping
skills needed to help manage diabetes and its complications
 Medicines to control cholesterol and blood pressure

8. Mechanisms for Diabetes-Perio
Relationship
 Altered host response
 Alterations in connective tissue and wound
healing
 Microangiopathy
 Alterations in gingival crevicular fluid
 Altered subgingival microflora
(composition/virulence)
 Hereditary predisposition
Taylor 2004 Compendium

9. Periodontal Therapy and Insulin
Resistance
 Only one clinical trial among type 2 diabetes patients
showed that periodontal therapy was associated with
decreased insulin resistance. Talbert J et al. J Dent Hyg.
2006
 Some RCTs showed positive findings; others showed no
significant reduction in the level of plasma glucose.
 Inconsistent results from cross-sectional studies

10. Conclusions for Diabetes Periodontitis
Association
 The association between periodontitis and type 2
diabetes is potentially bidirectional, but neither
direction has been established
 Periodontal treatment including antibiotics could lead
to improvement in HbA1c
 Periodontitis is associated with several risks factors for
diabetes as well as with diabetes complications
 More well designed longitudinal studies and clinical
trials are needed

11. Complications of Diabetes
 Microvascular complications include
 Neuropathy
 Nephropathy
 Vision disorders
 Macrovascular complications include
 Heart disease
 Stroke
 Peripheral vascular disease
 Periodontal disease is also considered a
complication of diabetes

12. Complications of Diabetes
 Microvascular complications include
 Neuropathy
 Nephropathy
 Vision disorders
 Macrovascular complications include
 Heart disease
 Stroke
 Peripheral vascular disease
 Periodontal disease is also considered a
complication of diabetes

13. Diabetes and Periodontal Disease