People who use e-cigarettes, cigarettes or both face an increased risk for developing diabetes, according to new University of Georgia research.
Smokers were significantly more likely to be diagnosed with prediabetes and diabetes than nonsmokers, the study found.
"In an era when e-cigarettes are marketed as a 'safer' alternative to smoking, this suggests they may carry a hidden peril and may be quietly contributing to long-term health problems like prediabetes and diabetes," said Sulakshan Neupane, lead author of the study and a doctoral student in the UGA College of Agricultural and Environmental Sciences. "As the use of e-cigarettes rises rapidly, it's vital we understand their broader health impacts. This is not just about the lungs anymore but the entire body and metabolic health."
The use of electronic cigarettes, also known as vaping, is increasing, particularly among youth, according to the Centers for Disease Control and Prevention. The findings of the new study suggest rates of diabetes may continue to climb as well for this group.
Additionally, researchers found the risk of developing diabetes or prediabetes is even greater for Hispanic and Black populations in poor socioeconomic conditions, as well as those who have underlying health conditions.
Using cigarettes, e-cigarettes together increases risk of prediabetes by 28%
Utilizing over 1.2 million data points from the Behavioral Risk Factor Surveillance System survey, the researchers analyzed e-cigarette and standard smoking use, and how it correlated to both prediabetes and diabetes diagnoses.
The study found vaping was associated with a 7% increased risk of prediabetes. E-cigarette use may cause short-term insulin resistance and weight gain, both risk factors for prediabetes.
That may seem like a small increase, but it translates to an additional 7,000 cases of prediabetes each year in the U.S based on current rates.
Smoking traditional cigarettes and cigars raised that risk to 15%. For people who vaped and smoked, the risk was even greater at 28%.
Users of cigarettes and both cigarettes and e-cigarettes also had higher odds, 7 and 9% respectively of being diagnosed with diabetes in general as well, not just developing risk factors for it.
"E-cigarette use alone elevates the likelihood of prediabetes, with dual use conferring an additional risk. This study highlights potential compounding harm from using both product types," said Neupane.
Pre-existing conditions, demographics could exacerbate diabetes risk
Researchers found a variety of characteristics could further elevate the risk of prediabetes and diabetes diagnoses.
Being overweight or obese while smoking increased the chances of developing these conditions, as e-cigarette users with a higher body mass index experienced worse outcomes than normal-weight vapers.
Hispanic, Black and Asian individuals who smoked or vaped were more likely to be diagnosed with prediabetes or diabetes than white people.
People in lower income categories likewise faced a higher risk (12%) of both conditions.
"People who aren't earning enough money experience mental stress and tend to smoke or use alcohol to reduce that stress, which leads to these increased risk factors," Neupane said.
But regular exercise made a difference, cutting the risk of prediabetes for smokers down by 8%, which researchers say offer a chance at mitigation.
"These findings have important implications for public health efforts to curb smoking and improve diabetes outcomes," said Neupane.
This study was published in AJPM Focus. Co-authors included are Agricultural and Applied Economics Professor Wojciech J. Florkowski and Chandra Dhakal, a Ph.D. graduate from UGA who now works for the CDC Foundation.
