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• Why Smoking Increases The Risk Of Heart Disease And Strokes 

Researchers at Charles Drew University of Medicine and Science in Los Angeles and Western University of Health Sciences in Pomona have discovered a reason why smoking increases the risk of heart disease and strokes.

The study, which will be presented June 11 at The Endocrine Society's 91st annual meeting in Washington, D.C., found that nicotine in cigarettes promotes insulin resistance, a pre-diabetic condition that raises blood sugar levels higher than normal. People with pre-diabetes are at greater risk of developing cardiovascular disease.

Theodore Friedman, MD, Ph.D., chief of the endocrinology division at Charles Drew University, said the findings help explain a "paradox" that links smoking to heart disease.

Smokers experience a high degree of cardiovascular deaths, Friedman said. "This is surprising considering both smoking and nicotine may cause weight loss and weight loss should protect against cardiovascular disease."

The researchers studied the effects of twice-daily injections of nicotine on 24 adult mice over two weeks. The nicotine-injected mice ate less food, lost weight and had less fat than control mice that received injections without nicotine.

"Our results in mice show that nicotine administration leads to both weight loss and decreased food intake," Friedman said. "Mice exposed to nicotine have less fat. In spite of this, mice have abnormal glucose tolerance and are insulin resistant (pre-diabetes)."

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• Nicotine induces prediabetes, likely contributes to high prevalence of heart disease in smokers 

Researchers have discovered a reason why smoking greatly increases the risk of heart disease and stroke. Nicotine promotes insulin resistance, also called prediabetes, which is a risk factor for cardiovascular disease, according to the new study, which was presented at The Endocrine Society's 91st Annual Meeting in Washington, D.C.

Additionally, the study authors were able to partially reverse this harmful effect of nicotine in mice by treating them with the nicotine antagonist mecamylamine, a drug that blunts the action of nicotine.

The study, which the National Institutes of Health funded, was conducted by researchers at Charles Drew University of Medicine and Science in Los Angeles and Western University of Health Sciences in Pomona, Calif.

Their results may explain why cigarette smokers have a high cardiovascular death rate, even though "smoking causes weight loss, which should protect against heart disease," said the study's lead author, Theodore Friedman, MD, PhD, chief of the endocrinology division at Charles Drew University.

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E-Cigarettes May Be An Alternative For Those Who Can't Use Nicotine Patches Or Gums 

"I can't use nicotine patches because I'm diabetic," says Linda of Benton County, Tennessee. "And the gums make me sick. I know I need to quit, but it's a mental addiction."

Linda isn't alone, because approximately 8% of the population in the United States is diabetic. Warnings on nicotine patches state that insulin-dependent diabetics should not use nicotine patches, but e-cigarettes, with physician approval, may be an acceptable alternative.

"We don't want anyone who's diabetic to have this "ah-ha!" moment and run out to buy an e-cigarette just because we say it may be an alternative to the nicotine patches they aren't able to use," says Tiffany of Ecigarettesnational.com. "We're not doctors here. We just want people to be aware that there could be potential and to talk to their doctor before making a decision. Medical conditions such as diabetes have to be managed very carefully and we don't want to put anyone in danger by telling them to "go, switch now, buy TODAY"."

In contrast, pregnant women are unable to use nicotine patches or gums, but are also not able to use e cigarettes, according to retailers and manufacturers.

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Abstract: Lifestyle Risk Factors and New-Onset Diabetes Mellitus in Older Adults: The Cardiovascular Health Study 

Conclusion

Even later in life, combined lifestyle factors are associated with a markedly lower incidence of new-onset diabetes mellitus.

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Lifestyle Factors Related To Risk Of Diabetes Among Older Adults 

Even for older adults, lifestyle factors such as physical activity, dietary habits, tobacco and alcohol use and the amount of body fat are associated with risk of new-onset diabetes, according to a study published in the April 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

"Given medical challenges, health care costs, long-term complications and growing incidence and prevalence of type 2 diabetes mellitus, preventing the onset of clinical diabetes is of paramount importance," the authors write. While previous studies have found lifestyle factors such as level of physical activity, diet, smoking habits, alcohol use and body fat levels as risk factors linked to onset of diabetes in younger populations, the combined impact of these factors on risk of diabetes in older adults is largely unknown.

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Lifestyle Factors Tied to Older Adults' Diabetes Risk  

Numerous lifestyle factors affect older adults' risk of diabetes, a new study finds.

U.S. researchers analyzed the link between lifestyle and incidence of diabetes over 10 years in 4,883 men and women aged 65 and older. The lifestyle factors examined included physical activity, dietary habits, tobacco and alcohol use, and amount of body fat.

The study authors found that each of these lifestyle factors was independently associated with incidence of diabetes. Overall, each positive score in a lifestyle factor was associated with a 35 percent lower risk of diabetes among those with a low-risk lifestyle.

People with good physical activity and dietary habits had a 46 percent lower incidence of diabetes. Those classified as low-risk based on their physical activity, dietary habits, smoking habits, and alcohol consumption had an 82 percent lower incidence of diabetes. Not having those four low-risk lifestyle habits appeared to be associated with 80 percent of new cases of diabetes. . . .

The study is published in the April 27 issue of the Archives of Internal Medicine.

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Utah American Indians Battle High Rates Of Chronic Illness  

A new Utah Department of Health (UDOH) report uncovers health issues among the state's American Indian population, whose members are disproportionately affected by chronic health problems:

- More than 11% of Utah's American Indian population has diabetes, compared with 6% of all Utahns. . . .

- The adult Utah American Indian asthma rate of 11.5% exceeds the state rate of 7.9%.

- 20.5% of Utah American Indians report poor physical health, compared to 13.9% of all Utahns, . . .

The Utah American Indian smoking rate of 21.2% is nearly double the state rate of 11.1%. Addictive commercial tobacco products are linked to many chronic health problems. Smoking commercial cigarettes constricts blood vessels and impairs circulation, increasing the risk of amputations in diabetics. Exposure to cigarette smoke can trigger asthma attacks and can lead to the development of asthma in children. UDOH is working to combat these problems. The Tobacco Prevention and Control Program has been funding the American Indian community coalition, Networking to Keep Tobacco Sacred in Utah, which works to distinguish between traditional and commercial forms of tobacco and to reduce the use of commercial tobacco among

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Cigarette Smoking and Risk of Gestational Diabetes: A Systematic Review of Observational Studies 

Gestational diabetes is a prevalent disease associated with adverse outcomes of pregnancy. Smoking as been associated with glucose intolerance during pregnancy in some but not all studies. Therefore, we aimed to systematically review all epidemiological evidence to examine the association between cigarette smoking during pregnancy and risk of developing gestational diabetes mellitus. . . .

Conclusion: The number of studies is small, with major heterogeneity in research design and findings. Taken together, current data do not support an association between cigarette smoking during pregnancy and the risk of gestational diabetes.

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Health Tip: Smoking and Diabetes How lighting up can worsen your health  

Smoking is harmful for everyone, but it can be particularly dangerous for diabetics, who are already at risk of complications such as cardiovascular disease.

If you're a diabetic who has smoked, no matter how long, you can improve your health by quitting. The American Diabetes Association offers this list of potential dangers for diabetics who smoke:

* Smoking decreases oxygen in the tissues, which can lead to a heart attack or stroke.

* Smoking increases cholesterol and blood pressure, which raises your risk of heart attack.

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LETTER: SMOKING IN AMERICAN INDIAN AND ALASKA NATIVE PEOPLE WITH DIABETES REVISITED ($$) 

Morton et al's article on smoking and diabetes in American Indians and Alaska Natives raises important concerns.1 Because of the longstanding organized emphasis on smoking ascertainment and cessation for individuals with diabetes, the findings likely reflect a serious ascertainment bias.

The Indian Health Service (IHS) Division of Diabetes has measured smoking status in American Indians and Alaska Natives with diabetes since 1986 with the Annual Diabetes Care and Outcomes Audit.2 The IHS Standards of Care for Diabetes emphasize smoking assessment. In 2007, 91.8% of patients with diabetes, systemwide, were assessed for tobacco use. Less than a quarter (23.4%) reported current . . . [Full Text]

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Quitting Time: A Look at Smoking and Preventing Diabetes and Heart Disease 

It's well known that smoking causes cancer. But did you know that smoking may also raise your risk for type 2 diabetes? Or that it is a major factor in nearly half of heart attacks? It's never easy to stop smoking, but millions of people have quit -- and you can, too. Now might be the time to give it a try.

Cigarettes contain more than 4,000 chemicals, including ammonia and substances found in rat poison. No matter how long you've smoked, you'll be healthier just 20 minutes after you quit, as your pulse rate goes back to normal. That reduces the stress on your heart. After just three days, the nicotine leaves your body and each breath comes easier. What about financial benefits? A pack-a-day smoker saves about $150 after one month without cigarettes, more than $1,800 after one year and close to $50,000 after 25 years.

About four out of five smokers would like to quit. Are you one of them? Here are some tips to get smoke-free:

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Global Update - Noninfectious Illnesses Are Expected to Become Top Killers 

As the world’s population ages, gets richer, smokes more, eats more and drives more, noncommunicable diseases will become bigger killers than infectious ones over the next 20 years, the World Health Organization is reporting.

The report, World Health Statistics 2008, shows that diseases like diarrhea, AIDS, tuberculosis, neonatal tetanus and malaria will become less important causes of death as heart disease, cancer, stroke, diabetes and traffic accidents claim greater percentages of victims. . . .

Dr. Ties Boerma, director of health statistics for the agency, said he had seen more obese people and more smokers in capitals around the developing world.

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Inhaled Insulin Associated with Excess of Lung Cancer Cases  

The FDA has warned that more cases of lung cancers have been reported in patients treated with the inhaled insulin Exubera than in controls in clinical trials.

The warning is another blow to the star-crossed Exubera, which was hailed as the only new method of delivering insulin in 80 years when it was approved in 2006 (See: FDA Okays Inhaled Insulin for Type 1 and 2 Diabetes).

However, less than two years later, Pfizer, the drug's maker, said it was phasing the drug out because patients and doctors had been slow to accept it (See: Citing Lack of Acceptance, Pfizer Pulls Plug on Inhaled Insulin).

Some patients continue to use Exubera, especially those on Pfizer's extended transition program, initiated when the company pulled the plug on the medication.

In the clinical trials, the FDA said, there have been six newly diagnosed cases of primary lung cancers among Exubera patients and only one among controls treated with comparator medications. . . .

The FDA said there have been "too few cases to determine whether the emergence of these events is related to Exubera" and the agency pointed out that all patients diagnosed with lung cancer had a history of cigarette smoking.

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• MannKind ends partner talks on inhaled insulin  

MannKind Corp said on Thursday it was suspending talks with potential partners for its experimental form of inhaled insulin due to negative market sentiment about such products, given possible cancer risks of Pfizer Inc's Exubera product.

MannKind's experimental form of inhaled insulin, Technosphere Insulin, is begin tested in a broad group of patients with diabetes, but data from late-stage trials of the medicine have not yet been obtained.

"At this time, we believe that we will be unable to achieve an appropriate valuation for Technosphere Insulin until Phase 3 data are available that confirm our belief in the safety and efficacy" of the product, MannKind said in a release.

Shares of MannKind plunged 60 percent to $2.35 on Wednesday after Pfizer and its former partner, Nektar Therapeutics, said six of the 4,740 patients given Exubera in clinical trials developed lung cancer. That compared with one of the 4,292 patients in the same trials who did not receive Exubera.

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MannKind shares rise; co. says inhaled insulin treatment is well tolerated 

Shares of MannKind Corp. (NASDAQ:MNKD) rose in early trading Thursday, after the company said its inhaled insulin treatment has a strong safety profile with no indication of carcinogenic potential.

The shares rose 4.3% to $2.43.

The stock sank dramatically Wednesday as investors and analysts reacted to the news that competitor Nektar Therapeutics (NASDAQ:NKTR) has suspended all further research on an inhaled insulin product, a treatment that MannKind is also developing.

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