Cigarette + electronic cigarette = double enjoyment?

*Only for medical professionals to read for reference.
Traditional cigarettes increase the risk of insulin resistance by more than 70%! The risk of two types of insulin resistance doubles this article summary Traditional cigarettes + e-cigarettes, the risk of diabetes may double! Smoking only: One, two, three hands, there is always one hand to pit you! Don't smoke: Although quitting smoking is fat, getting fat will be healthier! Smoking increases the risk of diabetes, so is it okay to switch to e-cigarettes? wrong! Traditional cigarettes and e-cigarettes are as easy to get diabetes! A recent study from South Korea found that smoking traditional cigarettes increased the risk of insulin resistance by more than 70%! The risk of two kinds of insulin resistance is doubled, and insulin resistance is the prelude to diabetes! A traditional cigarette + electronic cigarette, the risk of diabetes may double! Diabetes is currently one of the largest public health problems in the world.
About 90% of diabetic patients are type 2 diabetes (T2DM) patients, and insulin resistance is the most important feature of T2DM and a prelude to T2DM
.

Although the number of traditional cigarette smokers is gradually decreasing, the emergence of electronic cigarettes has increased the number of dual smokers who smoke both cigarettes and electronic cigarettes
.

Smoking increases the risk of insulin resistance, but is it okay for e-cigarettes? Will smoking cigarettes and e-cigarettes bring double harm? A recent study published in J Clin Endocrinol Metab evaluated the relationship between insulin resistance and two types of smoking
.

Figure 1 The study was published in J Clin Endocrinol Metab.
This study from Yonsei University in South Korea [1] used data from the National Health and Nutrition Examination Survey of South Korea.
A total of 11,653 participants were included, including 4,721 men and 6,932 women
.

Among them: 3.
9% of men and 0.
5% of women smoke both cigarettes and e-cigarettes; 29.
9% of men and 4.
5% of women only smoke but do not smoke e-cigarettes
.

The analysis showed that compared with non-smokers, the risk of insulin resistance as defined by the HOMA-IR index of male smokers increased by 78% (OR 1.
78), and female smokers increased by 76% (OR 1.
76)
.

For dual smokers, regardless of whether they are male or female, their risk of insulin resistance doubles (OR 2.
19; OR 2.
32)
.

Researchers pointed out that both traditional cigarette smoking and double smoking increase the risk of insulin resistance
.

In fact, the combination of e-cigarettes + traditional cigarettes may not be able to partially replace cigarettes with e-cigarettes, achieving a more "healthy" effect, but will give cigarettes an extra bonus, making the risk of insulin resistance steadily increasing
.

Two smoking: one, two and three hands, there is always one hand to pit you! The adverse effects of smoking on endocrine metabolism, in addition to increasing the risk of insulin resistance, will also actually increase the risk of T2DM
.

In addition to the smokers themselves, even those who smoke second-hand smoke around them can hardly escape
.

A study published in Lancet Diabetes Endocrinol in recent years comprehensively analyzed the effects of active smoking and passive smoking on the risk of diabetes
.

Figure 2 Study published in Lancet Diabetes Endocrinol This meta-analysis from Tongji Medical College of Huazhong University of Science and Technology [3] included 88 prospective studies involving 5,898,795 participants and 295,446 T2DM patients
.

The results found that compared with non-smokers, the risk of T2DM among people who are still smoking increased by 37% (RR 1.
37); the risk of T2DM among former smokers also increased by 14% (RR 1.
14)
.

Even if some people stay away from tobacco, they may suffer because of smokers around them.
The risk of T2DM for such people will increase by 22% (RR 1.
22)
.

The more you smoke, the higher the risk of T2DM
.

The researchers also analyzed the risk of diabetes in light smokers who smoked 20 packs/year, moderate smokers who smoked 20-40 packs/year, and heavy smokers who smoked 40 packs/year or more
.

Compared with never-smokers, the risk of diabetes in light smokers increased by 21% (RR 1.
21), the risk of moderate smokers increased by 34% (RR 1.
34), and the risk of heavy smokers increased by as much as 57% ( RR 1.
57)
.

Approximately 11.
7% of men and 2.
4% of women worldwide suffer from type 2 diabetes because of smoking
.

Figure 3 The more you smoke, the higher your diabetes risk.
The effects of smoking are in the visible first-hand and second-hand smoke, as well as the invisible third-hand smoke
.

Third-hand smoke refers to the tobacco smoke pollutants remaining on the surface and dust of objects after smoking, which are discharged into the air or react with oxidants and other compounds in the environment to produce secondary pollutants
.

Even this residual cigarette can have a potential impact on health
.

A previous study published in Environmental Research [4] pointed out that the nicotine, nitrosamine and cotinine components in third-hand cigarettes are toxic to cells, disrupt normal metabolism, and even affect blood sugar
.

Figure 4 Research published in Environmental Research Three Don't Smoking: Quit smoking, although you are fat, you will be healthier if you get fat! If smokers do not want to get diabetes, quitting smoking is also one of the methods
.

A previous study by Chinese scholars published in Lancet Public Health[5] found that Chinese people can stay away from the risk of diabetes by quitting smoking for 5 years
.

This study used the data of more than 500,000 Chinese participants in the China Chronic Disease Prospective Study Series to monitor the incidence of diabetes in the participants during a 9-year follow-up period, and assessed the relationship between different smoking status and the risk of diabetes
.

Figure 5 The study published in Lancet Public Health shows that after 5 years, those who quit smoking for their own health will have the same risk of developing T2DM as those who have never smoked (HR 0.
92)
.

If, as a smoker, you have not repented after reading this article, and you have to quit smoking passively due to illness until you are sick, then you need to quit smoking for 15 years to reduce the risk of T2DM to the same level as those who have never smoked.
Level (HR 1.
17)
.

A study recently published on JAMA Netw Open [7] also began to persuade everyone to quit smoking
.

This study included 1663 participants from Australia and analyzed the changes in body weight and changes in the risk of various chronic diseases and deaths among ex-smokers and continuous smokers
.

It turns out that quitting smoking does make many people gain weight, but even if they gain 10kg, quitting smoking is still beneficial
.

Figure 6 The results of the study published in JAMA Netw Open showed that the death risk of people who lose weight after quitting smoking is half of that of continuous smokers (HR 0.
50); ​​people who lose weight after quitting smoking will reduce the risk of death by 21% (HR 0.
79); After quitting smoking, gaining 10kg of weight will still reduce the risk of death by 64% (HR 0.
36)
.

Compared with continued smokers, weight gain after quitting smoking does not significantly increase the risk of cardiovascular disease, type 2 diabetes, cancer and chronic obstructive pulmonary disease.
Of course, diabetic patients should quit smoking
.

A study on Lancet Diabetes Endocrinol[8] analyzed 10809 T2DM patients and found that T2DM patients who had quit smoking for 2-6 years had a significantly lower risk of cardiovascular disease than continuous smokers (HR 0.
83); and those who had quit smoking for more than 6 years In patients with T2DM, cardiovascular risk is even lower than that of continuous smokers (HR 0.
72)
.

Weight gain after smoking cessation has no significant effect on the overall risk of death, cardiovascular death and cancer death
.

Figure 7 Research published in Lancet Diabetes Endocrinol Summary Smoking and e-cigarette use increase the risk of insulin resistance and T2DM, and smoking cessation is the only way to avoid these risks
.

The short-term weight gain after quitting smoking may have some impact on the risk of T2DM and other chronic diseases, but the decrease in the risk of death is real
.

Patients with type 2 diabetes have a high risk of cardiovascular events and death, so they should quit smoking to avoid worsening the situation
.

Related Article👇Smoking exacerbates death, and six years of quitting can be saved! NEJM three consecutive calls for tobacco control reference materials: [1] Jeong SH, Joo HJ, Kwon J, Park EC.
Association between Smoking Behavior and Insulin Resistance Using Triglyceride-Glucose Index among South Korean adults.
J Clin Endocrinol Metab.
2021 Jun 23: dgab399.
doi:10.
1210/clinem/dgab399.
Epub ahead of print.
PMID:34160623.
[2]Orimoloye OA,Uddin SMI,Chen LC,Osei AD,Mirbolouk M,Malovichko MV,Sithu ID,Dzaye O,Conklin DJ,Srivastava S,Blaha MJ.
Electronic cigarettes and insulin resistance in animals and humans: Results of a controlled animal study and the National Health and Nutrition Examination Survey(NHANES 2013-2016).
PLoS One.
2019 Dec 31;14(12):e0226744.
doi:10.
1371/journal.
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PMID:31891598;PMCID:PMC6938328.
[3]Pan A,Wang Y,Talaei M,Hu FB,Wu T.
Relation of active,passive,and quitting smoking with incident type 2 diabetes :a systematic review and meta-analysis.