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Diabète de type 2, la cigarette a sa part de responsabilité

On le sait trop peu mais le tabagisme est un facteur de risque de diabète de type 2 : le risque pour un fumeur est augmenté de 30 à 40 %. La bonne nouvelle est que tout peut revenir à la normale en écrasant sa dernière cigarette.  

« Le risque de développer un diabète pour un fumeur est augmenté de 37 % par rapport à un non-fumeur, précise le Pr Ivan Berlin, pharmacologue (CHU Pitié-Salpêtrière, Université Paris 6, INSERM U1178), avec une relation dose-dépendante en fonction du nombre de cigarettes quotidiennes. Le tabagisme augmente le risque de survenue de syndrome métabolique et de diabète de type 2 et va de pair avec une accumulation de graisse abdominale et une résistance à l’insuline. La survenue de cas de diabète est plus que doublée chez les fumeurs, comparé aux non-fumeurs ».

Laisser tomber la cigarette ? Le jeu en vaut la chandelle. La liste des risques encourus par le diabétique fumeur est particulièrement longue avec, tout d’abord, un risque de décès bien supérieur (+ 58 % de mortalité toutes causes) et du même ordre que celui de maladie des artères coronaires et d’accident vasculaire cérébral (AVC). La proportion de personnes avec un diabète mal équilibré est aussi plus importante. Idem pour la micro-albuminurie (témoignant d’une anomalie de la fonction des reins), qui est plus élevée parmi les diabétiques fumeurs (de type 1 ou de type 2) que parmi les diabétiques non-fumeurs. De plus, le tabagisme peut augmenter le risque d’hypoglycémies sévères et d’humeur dépressive.

Le constat que tout peut revenir à la normale après l’arrêt de la consommation tabagique devrait motiver le sevrage tabagique. En effet, les ex-fumeurs ont un risque de diabète qui ne diffère pas de celui des non-fumeurs.

Le tabagisme est un risque cardiovasculaire qui se surajoute au risque cardiovasculaire déjà plus élevé des diabétiques. A l’arrêt du tabac, ce sur-risque se normalise, mais le diabétique qui s’arrête de fumer conserve toutefois son risque cardiovasculaire dû au diabète. 

HJ

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