Is the consumption of cigarettes, e-cigarettes, or nicotine packets linked to an increased risk of developing type 2 diabetes?
In a groundbreaking study presented at the annual meeting of the European Association for the Study of Diabetes (EASD), researchers have found that smokeless tobacco products, such as e-cigarettes and nicotine pouches, can also heighten the risk of developing type 2 diabetes.
The study, led by Emmy Keysendal, a PhD student at the Institute of Environmental Medicine, Karolinska Institutet, Sweden, analysed medical data from over 3,300 people with type 2 diabetes and almost 3,900 controls. The participants were divided into four different type 2 diabetes subtypes: Mild age-related diabetes (MARD), Mild obesity-related diabetes (MOD), Severe insulin-deficient diabetes (SIDD), and Severe insulin-resistant diabetes (SIRD).
The findings revealed that smokeless tobacco use, specifically oral tobacco products like snus, increases the risk of developing SIDD by 19% and SIRD by 13%. Moreover, ever-smokers also increased their risk for SIDD by 20%, MARD by 27%, and MOD by 29%.
Emmy Keysendal suggests that the link between smokeless tobacco and diabetes risk might be due to nicotine, particularly its effects on insulin resistance. David Cutler, a board certified family medicine physician, expressed concern about the cause-and-effect relationship in studies like this, considering uncontrolled variables such as diet, exercise, and weight.
While the potential impact of smoking on diabetes risk is important to study, there exists a myth that smoking may lower diabetes risk due to its potential effect on appetite and weight. However, Cutler stated that this study helps destroy that myth.
In future research, Keysendal's team will continue to investigate how modifiable risk factors, including genetics, combine to shape the different forms of diabetes, with the goal of improving prevention. Cutler suggested that future research should look at non-smoking causes that increase the risk of type 2 diabetes, such as weight, diet, activity levels, and genetic factors, to recognize people at high risk and to make them more aware of the need to change known behaviours like diet and exercise.
Approximately 11% of the world's population lives with diabetes, with 90% having type 2 diabetes. The new study reconfirms smoking as a major risk factor for type 2 diabetes. The findings are yet to be published in a peer-reviewed journal.
