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Is smokeless tobacco harmful for diabetics?

Q: Is smokeless tobacco harmful if you are diabetic and the blood sugar fluctuates also? My husband wants to eat sweet stuff pretty often though he takes tablet for his diabetes. Does this show that diabetes is not under control?

A:Smokeless tobacco does contain nicotine and other harmful substances. The damage is more in diabetics, even more so if the diabetes is uncontrolled. If your husbands blood sugar levels fluctuate a lot, he should check them himself at different times of the day using a blood glucose meter. If his sugars are low, he may have a craving for sweets. However, he should not assume that craving for sweets means low sugars: he has to check and confirm. All diabetics need regular checks of blood sugar levels, and BP levels. BP should be maintained at normal (ie 120/ 80 mm Hg). They should also get HbA1c test done 2-4 times a year to see what overall diabetes control is like. In addition, they need an annual test of lipid levels, retina check, kidney function (serum creatinine, 24 hours urine for proteinuria) and ECG, to make sure that the chronic complications of diabetes are not developing.

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