According to the CDC,
- "Smokers are 30-40% more likely to develop type 2 diabetes than nonsmokers."
- Smokers with diabetes struggle with insulin dosing and control the diabetes.
- Smoking directly increases the risk of diabetes-related complications like heart failure and kidney failure.

Smoking is highly addictive due to the nicotine in cigarettes.
- So, if you're not smoking, don't start smoking.
- If you're trying to quit, see smokefree.gov for tools and resources. There's also a national quitline: 1-800-QUIT-NOW. It's never too late to quit smoking.

Smoking also increases the risk of lung cancer, COPD, and other terminal chronic diseases.

Type II Diabetes | Risk Factors | Tobacco Smoking

- Excessive alcohol use increases the risk of diabetes by potentially causing chronic inflammation of the pancreas. For more information, see Alcohol & Diabetes | American Addiction Centers.
- Heavy drinking** worsens diabetes symptoms.
     - As per Healthline Media, alcohol prevents the liver from regulating glucose levels since the liver must instead work to remove alcohol from the blood.
     - Alcohol interferes with diabetes medications (Healthline Media).
- Heavy drinking aggravates/causes diabetes complications, like heart disease, kidney failure, and nerve damage.
- Alcohol can be addictive. For resources on cutting down excessive drinking, see Thinking about a change? | NIAAA. You'll find Handling urges to drink | NIAAA especially helpful.

** Moderate drinking is defined as ≤ 1 drink per day for women and ≤ 2 drinks per day for men (AACR). Excessive drinking is normally defined as ≥8 drinks per week for men and ≥ 15 drink per week for women (CDC), but for some medical conditions any drinking is excessive. For full details on how much drinking is too much in general, see How much is too much? | NIAAA.`

Type II Diabetes | Risk Factors | Alcohol Use

- Excess abdominal fat is the number one leading cause of type 2 diabetes (Harvard T.H. Chan School of Public Health).
- Losing about 10-15 pounds can halve your chances of getting type 2 diabetes (Harvard T.H. Chan School of Public Health).
- This 1.5-min video (published by Diabetes UK) shows how excess body fat causes type 2 diabetes: https://youtu.be/7lNQ6SupQhE

Type II Diabetes | Risk Factors | Excess Abdominal Fat

According to Mayo Clinic and the CDC,
- Unhealthy eating can cause excess body weight, which is the leading preventable cause of diabetes.
- Unhealthy items include processed foods, sugar-sweetened drinks, refined grains.
- Healthy foods like whole grains, fruits, vegetables, and beans lowers the risk.

This 3-min video illustrates the importance of diet in diabetes prevention: https://youtu.be/-VB-QWM2RaY

Type II Diabetes | Risk Factors | Poor Diet

According to Get Active! | CDC and Healthcare Triage,
- Physical activity reduces stress and improves mood, hence reducing unhealthy behaviors like smoking, excess alcohol use, and unhealthy eating. In terms of diabetes prevention, physical activity improves insulin sensitivity.
- Sufficient physical activity (≥ 150 min of moderate activity per week for adults, 60 min daily for adolescents) benefits physical and mental health in several other ways, too.​
- Some physical activity is better than none.

This video shows (using peer-reviewed evidence) that exercise improves overall health in several ways, hence helping prevent and manage type 2 diabetes: https://youtu.be/SFBBjynBpSw

Type II Diabetes | Prevention | Physical Activity

According to the Harvard T.H. Chan School of Public Health,
- Most type II diabetes cases are preventable.
- To prevent type II diabetes (or stop/slow its progression if you already have it), avoid tobacco smoking, limit/avoid alcohol drinking, avoid excess abdominal fat, be physically active, and have a balanced diet**

** This does NOT mean that people who eat unhealthy food are always culpable. Factors like socioeconomic status can play heavily into this (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910945/).

University of Michigan - Ann Arbor

Insulin is produced but the body can't use it properly. This is due to insulin resistance. Earlier on in the disease, the pancreas tries to compensate by producing more insulin. However, later on, the beta cells in the pancreas wear out and insulin production decreases.


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