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• Exposure to secondhand smoke increases risk for Type 2 diabetes 

Chronic secondhand smoke exposure significantly increases the risk for Type 2 diabetes, show results from a study of Greek and Cypriot elderly men and women.

“While active smoking is strongly related to the development of diabetes mellitus, the role of exposure to secondhand smoke in the development of diabetes mellitus is unclear,” write Demosthenes Panagiotakos (Harokopio University, Athens, Greece) and colleagues in the journal Diabetic Medicine.

The researchers recruited 1190 elderly men and women aged 65 years or above from several Greek and Cypriot islands in the Mediterranean during 2005–2007.

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• Effects of Timing and Extent of Smoking, Type of Cigarettes, and Concomitant Risk Factors on the Association Between Smoking and Subclinical Atherosclerosis  

The purpose of this study was to evaluate the effects of timing and extent of smoking, type of cigarettes, and concomitant vascular risk factors (VRFs) on the association between smoking and carotid intima-media thickness (C-IMT) in a lipid clinic population. . . .

Conclusions-- In the present cross-sectional observational investigation, carried out in a cohort of patients attending a lipid clinic, consumption of light cigarettes does not reduce the atherogenic effect of smoking on C-IMT. The number of pack-years, cigarettes/d, and years of smoking are relevant covariates in evaluating the effects of smoking on vascular health. The presence of diabetes or hypertension strengthens the association between smoking and cardiovascular risk.

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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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• 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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• NICOTINE AND TYPE 2 DIABETES (PDF) ($$) 

ToxSci Advance Access published on March 18, 2008. doi:10.1093/toxsci/kfn050

Borowitz and Isom Toxicol. Sci..2008; 0: kfn050v1-kfn050

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• William F. Buckley Jr. Is Dead at 82  

William F. Buckley Jr., who marshaled polysyllabic exuberance, famously arched eyebrows and a refined, perspicacious mind to elevate conservatism to the center of American political discourse, died Wednesday at his home in Stamford, Conn.

Mr Buckley, 82, suffered from diabetes and emphysema, his son Christopher said, although the exact cause of death was not immediately known. He was found at his desk in the study of his home, his son said.

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• Smokers should be screened for type 2 diabetes, Harvard researchers say 

Smokers should be screened for type 2 diabetes and encouraged to quit smoking to prevent it, two Boston researchers recommend based on a new review of studies linking smoking and diabetes.

Already the leading cause of preventable death around the world, smoking has now been tied to a 44 percent higher risk of developing type 2 diabetes, Swiss researchers report in a review of 25 studies of 1.2 million people, published in tomorrow's Journal of the American Medical Association.

Two Harvard researchers, writing in an editorial that also appears in the journal, call on physicians to test smokers for diabetes and encourage them to quit.

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• Heart attack hits 20-plus age group 

Heartache and cardiac problems have emerged as the most common lifestyle and work-related diseases today. Earlier, people above the 40-45 age bracket were vulnerable to cardiac-related diseases.

“It’s quite surprising but nowadays, people below 30 are suffering from cardiac problems. Such cases are on rise,” said Shuvo Dutta, consultant cardiologist of BM Birla Heart Research Centre, who treated a 24-year-old youth, who had suffered a massive cardiac arrest. . . .

“Hypertension and stress in the workplace has increased manifold. Besides, odd working hours, rise in smoking and drinking habits and chewing of tobacco account for heart problems at a young age,” he pointed out.

“The alarming factor is the changing disease patterns, like early heart attacks and resultant myocardial damage, is much more severe,” observed Kunal Sarkar, cardiac surgeon of Rabindranath Tagore International Institute of Cardiac Sciences. . . .

One of the major factors responsible is rise in diabetes at an early age.

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• Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study -- Houston et al.  

What is already known on this topic

Smoking is hypothesised to increase insulin resistance

Results of previous observational studies assessing the association of smoking and incidence of diabetes have been mixed

What this study adds

A strong association existed between both active and passive tobacco smoke exposure and subsequent development of impaired fasting glucose or diabetes over 15 years

Among smokers, total pack years smoked was associated with increasing risk of incident diabetes

The association of tobacco exposure with diabetes was greatest among white men and women

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• Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study -- Houston et al. 

Median age at baseline was 25, 55% of participants were women, and 50% were African-American. During follow-up, 16.7% of participants developed glucose intolerance. A graded association existed between smoking exposure and the development of glucose intolerance. The 15 year incidence of glucose intolerance was highest among smokers (21.8%), followed by never smokers with passive smoke exposure (17.2%), and then previous smokers (14.4%); it was lowest for never smokers with no passive smoke exposure (11.5%). Current smokers (hazard ratio 1.65, 95% confidence interval 1.27 to 2.13) and never smokers with passive smoke exposure (1.35, 1.06 to 1.71) remained at higher risk than never smokers without passive smoke exposure after adjustment for multiple baseline sociodemographic, biological, and behavioural factors, but risk in previous smokers was similar to that in never smokers without passive smoke exposure.

Conclusion

These findings support a role of both active and passive smoking in the development of glucose intolerance in young adulthood.

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• Secondhand Smoke Linked to Diabetes Risk 

The long-term study of more than 4,500 American men and women found the incidence of glucose intolerance -- a precursor to diabetes in which the pancreas can no longer produce enough insulin to regulate blood sugar -- was directly related to exposure to tobacco smoke.

After 15 years of follow-up, the researchers found smokers had the highest risk of glucose intolerance, with 22 percent of them developing the condition. But 17 percent of those who never smoked but were exposed to secondhand smoke developed the condition, a rate higher than the 14 percent found in smokers who gave up the habit. Only 12 percent of people who never smoked developed glucose intolerance.

The researchers also found that whites were more susceptible to this effect than blacks.

The findings appear in the April 8 issue of the British Medical Journal.

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• Diabetes link to passive smoking 

Passive smoking increases the risk of developing diabetes, a study suggests.

A 15-year US study of 4,572 people backed earlier claims that smokers were at higher risk of developing glucose intolerance - a precursor to diabetes.

But it also found people subject to second-hand smoke had a slightly higher risk of diabetes.

The study, published in the British Medical Journal, suggests smoke toxins could affect the pancreas, which makes the blood sugar regulator insulin

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• Smokers More Likely to Develop Diabetes 

-- People who smoke are nearly three times as likely to develop diabetes as those who have never smoked, according to a study being published in the October issue of Diabetes Care. While previous studies have shown that smoking and diabetes can often lead to serious consequences, such as fatal heart attacks, this study investigated whether smoking can actually lead to diabetes.

A separate study in the October issue found that women who lived alone -- who smoked more, were less likely to drink alcohol and ate less nutritional meals -- were also more than twice as likely to develop diabetes as those who lived with others.

"We can't say it often enough: Lifestyle factors are the key to reducing your chances of developing diabetes," said Mayer B. Davidson, MD, editor of Diabetes Care and past president, American Diabetes Association. "Study after study shows us, the way to prevent this disease is to eat nutritious and well-balanced meals, lose weight if you are overweight or obese, exercise and for goodness sake, quit smoking!"

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• Smoking may increase risk of diabetes 

Smoking may increase the risk of developing diabetes, according to new research by investigators at Wake Forest University School of Medicine and colleagues.

The surprising finding emerged when researchers examined the relationship between smoking and diabetes among participants in a major national study, the Insulin Resistance Atherosclerosis Study (IRAS). They compared the incidence of diabetes after five years among smokers and those who had never smoked.

Twenty-five percent of the participants who smoked and did not have diabetes when the study began had developed diabetes by the five-year follow-up, compared to 14 percent of the participants who had never smoked, according to Capri G. Foy, Ph.D., and her colleagues at the national IRAS coordinating center at the School of Medicine, part of Wake Forest University Baptist Medical Center.

Reporting in the journal Diabetes Care, the researchers found that when the analyses were adjusted to account for other diabetes risk factors, "smokers still exhibited significantly increased incidence of diabetes compared to people who had never smoked," Foy said.

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