Hey there, Diabetes Friends! Receive back to our time period advice column, Ask D'Mine. I'm your friendly host, Wil Dubois — a old type 1 diagnosed as an adult who happens to write around diabetes and has worked as a objective diabetes specialist in New Mexico.

Yep, that's me. And I happen to enjoy an occasional puff on a cigar, apropos to this week's question from a afraid cleaning lady whose pal with type 2 has a love for cigars. She's worried about the blood sugar effects of smoky, indeed let Pine Tree State take a puff at that one…

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Custodian, type 3 from Palmetto State, writes: My brother has type 2 diabetes and atomic number 2 smokes these cigars called Sarcastic & Mild. I don't like them because I think they're making his blood glucose give way ascending, operating theatre his A1C, I don't know. He's 48, works every day, and he's constantly smoking those cigars. Do the cigars piss his blood glucose turn up?

Wil@Involve D'Mine answers: My blood clams usually goes push down when I weed a cigar, and I hate to bash 1 of my two favorite unhealthy vices, indeed I was going to answer you with a simple dismissive "No," and move on to the next dubiousness. On the other hand, in all fairness to you, I decided I'd ameliorate look into it.

And you may actually be on to something.

But let's be clear that while there's a short ton of research happening cigarette smoking, there's not so practically on cigars and pipes. I'm not sure what's up with that. It could be because throughout modern history, enounce from 1950 onward, cigarette smokers vastly outnumbered cigar and pipe smokers. Or it could be that the Centers for Disease Control (CDC) only tracks info on cigarette smoking, thusly there's to a greater extent information to figure out with on that point. OR IT could be because smoking cigars (surgery pipes), while non exactly healthy, isn't in reality as dangerous as smoky cigarettes.

This is because while fag smoke is inhaled directly into the lungs, a cigar or pipe is "puffed," with the smoke ingress but the mouth, then blown out again. On top of all of that, most of the research on smoking deals with its globally evil effects on the human body. Cancers and cardiovascular disease mainly, non so much pedigree carbohydrate control. And what little research we let along blood loot and cigarettes has focused on smoking Eastern Samoa a thinkable contributing factor in underdeveloped diabetes primarily, rather than on dominant blood sugar in existing diabetes.

Ironically, piece smoking cigarettes does appear to atomic number 4 linked to an increased risk of development type 2 diabetes, quitting might be the slam-dunk that makes you join our party. The peak risk period for developing diabetes is in reality cardinal years aft quitting—likely payable to the weight gain usually seen after boot the habit.

All of that said, still, in that location is emerging research linking nicotine to insulin resistance, and this is where things get interesting. Because it's not just cigarettes. Check out this study, which found that long-run utilize of nicotine gum is connected to increased insulin electric resistance!

So much for chew 'em if you got 'em.

I guess if the nicotine in in nic gum can resurrect your insulin resistance, and therefore perchance your stemma sugar, so as well could the nicotine in the generally safer cigars or pipes.

So I have to yield that there's a link betwixt smoking any kind of tobacco and increased insulin resistance. And it sure looks like nicotine, pardon the expression, is the smoking gun among the 4,000 operating theater so chemicals generated by a cigarette. But could smoking actually raise A1C? I laughed at the notion when I fist learn your electronic mail, but damned if I didn't find evidence that it could be possible.

Calif. Polytechnic professor Dr. Xiao-Chuan Liu exposed samples of hominian blood to nicotine and then tested the A1C of the samples. I was ineffective to locate the original written report, but a according to many reports, the more nic the blood was exposed to, the high the A1C. Manifestly, Liu added balanced amounts of sugar and multivariate amounts of nicotine to vials of blood and tested the A1C. His smallest nic sample elevated the A1C to 8.8. His largest to 34.5%.

But there are problems hither. He tested the blood after only a solar day or two, and the A1C test is planned to be a consider a three-month window; and it's generally accepted that a sugar spike right before the test has nary upshot on the result, so I'm a bit unbelieving about testing A1C thus soon after a flying glucose photograph.

I also birth no idea how his nic samples compared to the levels a real smoker gets, and of course this is all in test tubes, so who knows if it translates to the anthropomorphous body? And I besides don't sleep with how the nic load from a cigar compares to that of a butt.

Simply it is disturbing that jacking up the nic levels seems to have whatever sieve of burden connected the way blood cells react to sugar. In fact, the news has me thus stressed that I need to step outside and roll of tobacco a cigar.

That always brings my sugar bow out.Speaking of cigars and pipes, your brother's select of Black & Mild is interesting, because the product is actually a crossbreed of the two. According to the maker, they are cigars made from pipe tobacco: A toothsome bootleg Cavendish with Burley and golden Virginia tobaccos. I gotta try these…

Indeed, to answer your question: IT appears possible that smoking cigars all day long could raise your brother's blood glucose and A1C. By the way, you mightiness want to check out this thread of people comparison their real-humanity experiences with diabetes and cigars.

But the freighter line here is that in most cases there's no one single smoking gun—OR smoking cigar—that is the beginning of every blood sugar evils. Once you have diabetes, any frickin' affair can and will evoke your descent dough: food, stress, overwork, infection, miss of sleep, insufficient medication, medicines we take for other conditions, and more.

Some other thing to consider when weighing how big an wallop smoke has on either causation diabetes or making it harder to see, is the fact that while smoking is happening the decline, diabetes is on the rise. If nicotine were a big player in diabetes, the diabetes rate should be dropping.

Smoking latterly polish off an entirely-time low in our country. Lag diabetes is at an uncomparable high. In regard to smoky, about 17% of United States of America still smoke, down from a whopping 42.4% in 1965. Who smokes? More men than women. Kentuckians smoke the most, Beehive State citizens the least. Peak smoking historic period is between 25-44 eld old. Native Americans really, really, really like to smoking. Hispanics are cozy as. Asians are the smallest smoking demographic in the state. As learning levels go up, the smoky rates tend to go pull down. The poorer you are, the more likely you are to hummer.

And people with bendable notions of sexual orientation sess at a untold greater rate than heterosexual multitude.

Interestingly, masses with mental illnesses run through about a ordinal of the cigarettes smoked in the country, accordant to one field of study. That's because chain smoking is the top medicine for schizophrenic disorder. No shit. OR course, the side effect of chain smoking cigs is a lifespan up to 25 years shorter…

Merely I digress. Back to diabetes.

The key to diabetes control is achieving a Zen-like balance among all the things in your life that raise your blood sugar and the medicines you take to contain it. Simply quitting one of the numberless things that driving force sugar upward is supposed to instantly fix the job.

Still, you are right to worry about your brother. If his sugar is up, all manner of unsuitable things will befall to him long ahead the cigars take the opportunity to putting to death him. You say that your brother is middle-ripe and works every daylight. Bummer. On the working all the meter. There's nothing wrong with being old.

Soh what are his joys? Does atomic number 2 have a healthy hobby? Operating theater an alternate icteric by-line for that matter?

In my reckon, if the cigars are his main joy, taking them away doesn't leave him with much. In point of fact, the stress of quitting power make his parentage bread worse. Then he'll don weight and his scratch will get still worsened. I'm trusted the purists leave disagree with Pine Tree State, but my public opinion is that the outdo option is to simply medicate the effect of the cigars (if there is one) so that the diabetes, some the sidereal day-to-day blood sugars and the A1C, are controlled.

And LET the man smoke in peace.

Disclaimer: This is not a aesculapian advice pillar. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are non MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are but a small part of your tot up ethical drug. You soundless need the professional advice, treatment, and care of a licensed medical professional.