Smoking is bad for your health, that applies to everyone! Besides the fact that smoking tobacco damages the mucous membranes in your airways and is carcinogenic, smoking increases the risk of cardiovascular diseases. If you have diabetes, the risk of a cardiovascular disease is already increased, if you also start smoking this risk is increased even further.
An increased risk of cardiovascular diseases in patients with diabetes arises due to the following reasons: high blood sugars in diabetes damage the blood vessels. Sugars accumulate mainly in the walls of the small blood vessels. They become thicker, stiffer and can leak. Especially blood vessels in your skin and nerves become less functional. In addition, the fats accumulate in the vascular wall of your larger arteries, causing the vascular wall to become thicker and the opening of the blood vessel to become narrower. This means that even less blood can flow through the vessels. This is also called (stroke) artherosclerosis.
Diabetes can damage the heart. The blood vessels and nerves in your heart muscle can get damaged by the high blood sugar levels. This damage reduces the blood flow to the heart muscle which leads to insufficient oxygen-rich blood being available. Because of this, you can feel a pressing chest pain when you are exercising (called “angina pectoris”). The damage can also cause a heart attack, which happens when a blood vessel in the heart muscle is closed off. Part of the heart muscle then no longer receives oxygen-rich blood and dies. In the case that your neural pathways are also damaged, you might not feel the pain properly and do not recognize the alarm signal. If that is the case, a heart attack can proceed “quietly”: you don’t notice it, but it is still causing damage.