Development of glucose intolerance requires impairment of β cell function. Recent animal studies have shown that prenatal nicotine exposure, which is toxic to β cell mitochondria and leads to apoptosis, impairs pancreatic islet development [66,68], thus limiting β cell reserve; however, in one rat study, if nicotine exposure was not continued through both gestation and lactation, β cell recovery was still possible [83]. Maternal smoking during pregnancy has also been implicated in diabetes secondary to nonselective damage to the pancreas [84], and in association with β cell auto-antibodies, in young children