Diabetes Type 1 And Smoking

What is diabetes type 1?

Type 1 diabetes is a condition where your blood sugar level is too high because your body does not produce enough or any insulin. Insulin is a hormone that is produced by cells in your pancreas. However, in people with type 1 diabetes, the body attacks itself, destroying these cells. Insulin plays an essential role in allowing glucose in our blood to enter our cells to be used as energy to allow our bodies to function.1

After consuming carbohydrates, our body breaks this down into glucose and this enters our bloodstream. Without insulin, glucose cannot enter cells and builds up in the bloodstream, leading to high blood sugar levels. High blood sugar levels put pressure on small and large blood vessels, causing a number of problems. These include heart disease, nerves, eye, and kidney issues.1

Symptoms of type 1 diabetes include:

  • Weight loss
  • Frequent urination
  • Blurred vision
  • Irritability 
  • Sweet-smelling breath.

These symptoms are usually noticed in childhood. However, some people with type 1 diabetes do not get diagnosed until adulthood.

Treatment for type 1 diabetes is insulin injected daily and monitoring blood glucose. Whilst managing diabetes can take some time, it can rarely interfere with the normal life of the person.

Smoking doesn't cause diabetes type 1

The majority of type 1 diabetes is caused by the body attacking its own pancreatic cells and has nothing to do with diet or lifestyle.1 There is no evidence to suggest that smoking tobacco causes the destruction of pancreatic cells. However, smoking can increase the risk of diabetes-related complications as discussed earlier, and has been associated with a large number of health complications. Furthermore, nicotine found in tobacco can complicate the management of type 1 diabetes. For these reasons, smoking cessation is encouraged in people with and without type 1 diabetes.

Nicotine makes it harder to manage blood sugar

Nicotine is a drug found in tobacco and has many effects on the human body. For people with type 1 diabetes, it is important to note that nicotine can make your blood sugar levels increase through a number of mechanisms.2 This means that a larger amount of insulin would be needed in order to keep blood sugar levels under control. If your blood sugar levels are poorly managed, this could potentially speed up damage from having high blood sugar as your blood vessels will become damaged quicker.1

Nicotine lowers responsiveness to insulin

Nicotine has been shown to reduce insulin sensitivity and increase insulin resistance. This means insulin will not be able to do its job effectively.2 There are a few ways that nicotine does this. 

Firstly, nicotine stimulates your adrenal glands, which leads to an increase in cortisol (a hormone). However, it can counter the effects of insulin, reduce insulin sensitivity, increase insulin resistance and increase blood sugar. In excess, this will then cause high blood sugar levels leading to its effects.2

Secondly, nicotine has also been shown to stimulate the release of catecholamines, which are naturally occurring chemicals in the body, which can stop insulin from being produced.2 Somatotropic hormone plays a role in carbohydrate metabolism, leading to an increase in blood sugar levels.

Finally, nicotine-free cigarettes do not cause high blood sugar levels. This suggests that nicotine is indeed the culprit and should be avoided in order to make it easier for type 1 diabetics to control their blood sugar levels, which in turn will lead to a healthier and longer life.3

Is vaping safe when you have diabetes?

In recent years, vaping nicotine products have become a popular way to stop smoking and reduce the intake of nicotine. Vaping, however, still introduces nicotine into the body, which itself can cause issues with managing blood sugar levels. Vaping also brings unique problems associated with the lungs and heart due to chemicals in the liquid that is vaped, commonly known as e-liquid.4 Vaping is not safe for individuals with or without type 1 diabetes and people looking to quit smoking should look to consume nicotine through other methods in order to help them quit smoking.5

Tips on how to quit smoking

There are a number of reasons to stop smoking, whether you want to feel better, live a longer, healthier life, or simply save some money. Whatever the reason, here are some tips to help you quit.

  1. Find your local stop-smoking service.
  2. Use nicotine products like gum or lozenges.
  3. List reasons to quit
  4. Reduce smoking triggers
  5. Pick up a new hobby or exercise to keep cravings away.

One study suggests behavioral support combined with nicotine replacement therapy (patch or oral) is the most effective way to stop smoking.5


Type 1 diabetes is a condition that disrupts the balance of blood sugar in the body, caused by the body attacking itself and not through dietary or lifestyle factors. Therefore, smoking does not cause type 1 diabetes but is associated with its own health risk. Smoking introduces nicotine into the body which causes blood sugar to increase and can therefore complicate the management of blood sugar. Both vaping and smoking cessation are recommended and can greatly improve the lives of people with and without type 1 diabetes.


  1. Lucier J, Weinstock RS. Diabetes Mellitus Type 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Oct 3]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK507713/ 
  2. 2. Morgan TM, Crawford L, Stoller A, Toth D, Yeo K-TJ, Baron JA. Acute effects of nicotine on serum glucose insulin growth hormone and cortisol in healthy smokers. Metabolism [Internet]. 2004 [cited 2022 Oct 3]; 53(5):578–82. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0026049504000319
  3. 3. Bornemisza P, Suciu I. Effect of cigarette smoking on the blood glucose level in normals and diabetics. Med Interne [Internet]. 1980 Dec [cited 2022 Oct 3];18(4):353–6 Available from: https://europepmc.org/article/med/7455580
  4. 4. Tsai M, Byun MK, Shin J, Crotty Alexander LE. Effects of e‐cigarettes and vaping devices on cardiac and pulmonary physiology. J Physiol [Internet]. 2020 [cited 2022 Oct 3]; 598(22):5039–62. Available from: https://onlinelibrary.wiley.com/doi/10.1113/JP279754
  5. 5. Zwar NA. Smoking cessation. Australian Journal of General Practice [Internet]. 2020 [cited 2022 Oct 3]; 49(8):474–81. Available from: http://www.scopus.com/inward/record.url

Rob Reid

Master of Pharmacy - MPharm, Medway School of Pharmacy

Robert is a highly creative and technical individual with a strong scientific background and experience in both hospital and community pharmacy currently interning as a medical writer at Klarity.

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