Can Vaping Affect Your Blood Sugar?

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E-cigarettes have often been marketed as a safer alternative to smoking, but new research suggests that vaping may not be risk-free — especially when it comes to blood sugar and the risk of prediabetes and diabetes.

Vaping has become more common in the U.S., and researchers are still working to understand how it may affect long-term health. While previous research has shown that traditional cigarette smoking is linked to a higher risk of both prediabetes and diabetes, the relationship between e-cigarettes and these conditions is less known.

“Studies indicate that the connection between using e-cigarettes alone or combined with regular cigarettes and diabetes or prediabetes is unclear,” wrote lead investigator Sulakshan Neupane, MS, who is associated with the Department of Agricultural and Applied Economics at the University of Georgia. “Specifically, it remains unclear whether those who only use e-cigarettes, only use combustible cigarettes or use both are more likely to have diabetes or prediabetes than those who never smoke.”

The team looked at more than 1.2 million adults from the 2020–2022 Behavioral Risk Factor Surveillance System surveys to explore this connection. Participants reported whether they had been diagnosed with prediabetes or diabetes and whether they used e-cigarettes, traditional cigarettes or both (known as “dual use”).

To make the results more reliable, researchers used statistical methods to carefully match smokers and nonsmokers with similar backgrounds. This helped reduce the chance that differences in age, lifestyle or other health factors would skew the results.

What the study found:

• E-cigarette users: Adults who only used e-cigarettes were more likely to report having prediabetes compared to people who never smoked or vaped.
• Dual users (e-cigarettes + traditional cigarettes): Adults who used both were at even higher risk for prediabetes and were also more likely to report having diabetes compared to never users.
• Differences across groups: The risks were not the same for everyone. The study found some variation depending on demographics such as age, gender, or other characteristics.

Prediabetes was 7% higher for people who exclusively used e-cigarettes and 15% higher for traditional cigarette users compared with those who never smoked. The dual user group had 28% higher odds.

Traditional cigarette smokers had a 7% higher likelihood of developing diabetes, while the dual user group had a 9% increased risk. However, using e-cigarettes alone was not linked to diabetes in this study.

The findings suggest that e-cigarette use may not be harmless for metabolic health. While vaping alone was linked to prediabetes, combining vaping with smoking traditional cigarettes appeared riskier, raising the odds for both prediabetes and diabetes.

However, investigators noted some important limitations to keep in mind. The study was cross-sectional, meaning it looked at one point in time. This makes it impossible to know whether e-cigarette use caused prediabetes or diabetes. The data were self-reported, which can sometimes be inaccurate. Lastly, other unmeasured health factors could play a role. Because of these limitations, the team cautions against drawing firm conclusions and encourages conducting more long-term studies to truly understand how vaping and dual use affect diabetes risk.

For now, patients should be aware that e-cigarettes are not risk-free, especially for those concerned about blood sugar, prediabetes or diabetes.