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From South Africa:

  1. Why is smoking so bad for diabetics specifically? I can't quit, have tried. Will it be okay if I just smoke every second day?

  2. Why is drinking more than two glasses of dry wine an issue for diabetics?

  3. Should diabetics see an endocrinologist?


I will try to answer your questions in the order you asked them:

  1. Smoking is very bad for patients with diabetes. The complications of diabetes involve complications involving blood vessels. Smoking has a synergistic effect to damage blood vessels, in addition to the diabetes. The additive effect on vessels in the eyes, kidneys, nerves, heart, peripheral vessels, and brain are more than what would be considered the effects of adding the diabetes alone to the smoking alone. By stopping smoking, you are making an investment in your future health and quality of life. Your blood pressure will be easier to control and this also has an effect on the blood vessels mentioned above. No matter how many times you have tried to quit, it is worth another shot. The average smoker tries to quit seven times before they are successful. There is nothing more helpful to your health than to stop smoking. Please try again.

  2. Drinking in moderation has been shown to be neutral or even beneficial. Moderate drinking is usually two beers, two glasses of wine, or one shot of stronger drinks. More than that will have a pharmacologic effect to shut off glucose production from the liver and may induce low blood sugars in people taking insulin. In addition, the excess alcohol will raise triglycerides, lower HDL-cholesterol, and raise your blood pressure.

  3. Your third question is commonly asked. I would say that there are clearly defined goals for the treatment of diabetes. If you are not meeting them, you need to consider seeing someone who specializes in this disease. However, endocrinologists currently see only 10% of the patients with diabetes. That means our colleagues in general medicine need to be adept at treating diabetes, too. We need to work with them in order to raise the standards. For many cases of type 2 diabetes that are easily controlled, this is not a problem. Patients on insulin or patients with type 1 diabetes are more likely to need follow-up by physicians that are endocrinologists.


Original posting 15 Mar 2005
Posted to Behavior and Other


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Last Updated: Tuesday April 06, 2010 15:10:00
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