We all know nicotine consumption or heated not burnt (HNB) tobacco products in any form are bad, but did you know that it can lead to diabetes, too?

The current burden of diabetes is extremely high and is increasing every passing moment globally. In developing economies like India, it is mainly fueled by the accelerated prevalence of overweight, early obesity and unhealthy lifestyles like the increasing trend of consumption of nicotine products in school-going children, adolescents and young adults. The estimates in the year 2019 showed that 77 million individuals were diabetic in India, which is expected to rise to a whopping 134 million by 2045 which will have a worse outcome if associated with or triggered due to early nicotine consumption.

The Government of India in a futuristic approach realized the morbidity of this association and launched the National Programme for Prevention and Control of Cancer, Diabetes, heart Diseases, and Stroke (NPCDCS) in 2010. By March 2017, non-communicable disease cells which help with planning, monitoring, and reporting activities were been established in 390 (55%) of 719 districts by the govt of India which is a very good initiative to monitor and track the new cases and registered follow-ups for outcomes. Further, as diabetes is still not a notifiable condition, there are limited data available on patients treated in the private sector, thus its actual burden is unknown. As a result, the burden of diabetes in India might just be hugely underestimated as actually known.

Everyone knows nicotine consumption (Vaping) or heated not burnt (HNB) tobacco products as released via devices like IQOS, in any form is bad for you, but did you know it can lead to diabetes? And if you have diabetes, vaping can make it much worse. You might just get surprised and fearful to know how they’re connected and why quitting is still one of the best things you can do for your health.

Insulin present in our body helps blood sugar to enter inside cells away from the blood, but nicotine exposure brings changes in the cells so they don’t adequately respond to insulin, which increases blood sugar levels. Chemicals present in e-cigarettes or HNB are already proven to harm cells in your body and cause inflammation which makes cells stop responding to insulin thus worsening diabetes to a greater level. Nicotine consumers have a proportionately higher risk of belly fat, which increases the lipid constituents in the body (eg LDL, VLDL).

So if you still decide to use nicotine products either heated or heat not burnt types, you’re 30% to 40% more likely to get type 2 diabetes than people who don’t consume nicotine. The more you start early any form of nicotine consumption, the higher your risk, thus increasing your risk for type 2 diabetes even if you aren’t overweight.

Nicotine product use, which was accountable for 6% of the total disease burden in India in 2016, is another significant contributor to diabetes and heart disease now.

The Global Burden of Disease Study 2016, reported obesity and tobacco use to be one of the most important risk factors for death due to diabetes. Diabetes is a progressive disorder that leads to serious complications involving the eyes, kidneys, blood vessels, heart, and virtually all other systems of the human body, which are associated with increased costs to the family, community, and healthcare system. The “Global Burden of Disease study” conducted in 195 countries between 1990 and 2023 brought out the facts that the low- and middle-income regions had a higher burden of diabetes, while the high-income regions also were not much behind with a significant burden of diabetes which is directly proportional to their lifestyle disorders like early nicotine or its products related consumption pattern (vaping etc),

Bidi and raw tobacco consumption start from a young age in lower socioeconomic groups while vaping and HNB are catching faster as style statements in urban kids and adolescents cause this association between diabetes and nicotine consumption to grow happily and manifolds. Breaking the habit is one of the best things you can do for your health.

Managing diabetes is challenging, and vaping in any form can make it even more so. Nicotine increases your blood sugar levels and makes them harder to handle. People with diabetes who vape may often need larger doses of insulin to keep their blood sugar close to their target levels.

Merely treating diabetes might just not be sufficient as it will take care of only blood sugar levels, the simultaneous cessation of nicotine products needs to be the primary highlight in all sponsored or self-help programmes now. Sensitization over the direct risk link between diabetes and the early start of nicotine consumption has to be sincerely and seriously dealt with in all opportunities and fronts. The resistance to e-cigarettes menace causing increased numbers of potential diabetics or heart patients, has to continue.

(The writer is FIAGES FLCS FALS and Consultant Surgeon and industrial health expert. Views expressed are personal)