Did we miss this? The detrimental effect of nicotine on diabetes

[rothenbj]

Study Outlines Nicotine’s Harms for Diabetics | FairWarning

"Liu conducted his tests using blood from diabetic subjects, and lacing the samples with nicotine, which triggered the spike in blood sugar. The increase appears to indicate that nicotine is the key problem for diabetics — rather than, as WebMD said, one of the other more than 4,000 chemicals in cigarette smoke."

"The study “implies that if you are a smoker, and not diabetic, that your chances of developing diabetes [are] higher,” said Liu, who presented his findings at an annual meeting of the American Chemical Society."

Not sure if this study was brought up here before. I wish the search engine was a bit stronger on ECF (or perhaps I was better with it).

This has got to be conclusive proof, it came from Cali research.

 

[SonnyCrack]

Probably true.. After all, nicotine is a highly toxic poison.. I balk at those that compare it to caffeine.

 

[Vocalek]

Effects seen in the lab do not always match the effects observed in human populations.

Diabetes

A prospective cohort study by Eliasson et al (2004) considered the effect of snus use on diabetes in
men recruited from the two most northern counties of Sweden, where snus use is most prevalent. This well-conducted study detected no significant risk of diabetes for snus users, but confirmed the established finding of increased risk for diabetes from smoking. Statistical power was limited by the small number of cases of diabetes identified during follow-up (n=27). Follow-up was 8.7 years on average and the authors noted that the study participants were below the diabetes-prone age groups. Further investigation in prospective studies with longer follow-up is recommended, particularly in light of mixed results from cross-sectional research suggesting a link between snus use and type 2 diabetes (Persson et al. 2000).

Marita Broadstock. Systematic review of the health effects of modified smokeless tobacco products
NZHTA REPORT
February 2007
Volume 10 Number 1

 

[Vocalek]

And then there is this study, that included patients with diabetes. Safety profile of a nicotine lozenge compared with... [Clin Ther. 2005] - PubMed result

Clin Ther. 2005 Oct;27(10):1571-87.

Safety profile of a nicotine lozenge compared with that of nicotine gum in adult smokers with underlying medical conditions: a 12-week, randomized, open-label study.

Marsh HS, Dresler CM, Choi JH, Targett DA, Gamble ML, Strahs KR.


Source

GlaxoSmithKline Consumer Healthcare, Parsippany, NJ 07054, USA.


Abstract

BACKGROUND:

Nicotine polacrilex lozenges deliver 25% to 27% more nicotine compared with equivalent doses of nicotine polacrilex gum. The increased nicotine exposure from the lozenge has raised questions about the relative safety of the lozenge and gum.

OBJECTIVE:

The objective of this study was to compare the safety profiles of the 4-mg nicotine lozenge and 4-mg nicotine gum in smokers with selected label-restricted diseases.

METHODS:

This was a multicenter, randomized, open-label study in adult smokers with heart disease, hypertension not controlled by medication, and/or diabetes mellitus. Patients were randomized in a 1:1 ratio to receive the 4-mg nicotine lozenge or 4-mg nicotine gum. Safety assessments were made at baseline and at 2, 4, 6, and 12 weeks after the start of product use.

RESULTS:

Nine hundred one patients were randomized to treatment, 447 who received the lozenge and 454 who received the gum (safety population). The majority were women (52.7%). Patients' mean age was 53.9 years, their mean weight was 193.9 pounds, and they smoked a mean of 25.2 cigarettes per day at baseline. Five hundred fifty-three patients, 264 taking the lozenge and 289 taking the gum, used the study product for > or =4 days per week during the first 2 weeks (evaluable population). The nicotine lozenge and nicotine gum were equally well tolerated, despite increased nicotine exposure from the lozenge. The incidence of adverse events in the 2 groups was similar during the first 2 weeks of product use (evaluation population: 55.3% lozenge, 54.7% gum), as well as during the entire study (safety population: 63.8% and 58.6%, respectively). Stratification of patients by sex, age, extent of concurrent smoking, extent of product use, and severity of adverse events revealed no clinically significant differences between the lozenge and gum. The most common adverse events were nausea (17.2% and 16.1%; 95% CI, -3.7 to 6.0), hiccups (10.7% and 6.6%; 95% CI, 0.5 to 7.8), and headache (8.7% and 9.9%; 95% Cl, -5.0 to 2.6). Serious adverse events were reported in 11 and 13 patients in the respective groups. Fewer than 6% of patients in either group were considered by the investigator to have a worsening of their overall disease condition during the study. The majority of patients (>60%) experienced no change in their disease status from baseline.

CONCLUSION:

The 4-mg nicotine lozenge and 4-mg nicotine gum had comparable safety profiles in these patients with label-restricted medical conditions.

 

[Vocalek]

And one more study.

J Intern Med. 1996 Oct;240(4):189-94.

Effects of smoking cessation on insulin and cardiovascular risk factors--a controlled study of 4 months' duration.

Nilsson P, Lundgren H, Söderström M, Fagerström KO, Nilsson-Ehle P.


Source

Department of Community Health Sciences, Lund University, Sweden.


Abstract

OBJECTIVES:

To investigate the effects on serum lipids, plasma fibrinogen, plasma insulin, plasma C-peptide and blood glucose, of smoking cessation after 4 months. To develop a group-based smoking intervention programme in primary health care.

SETTING:

Twenty health centres in primary health care in southern Sweden.

SUBJECTS:

Four hundred habitual smokers (> 10 cigarettes per day-1, > 10 years), recruited by advertisement in local papers.

INTERVENTION:

The smokers were randomized, after stratification for age and sex, to one intervention group (n = 200) and one control group (n = 200). The intervention group was offered supportive group sessions and free nicotine supplementation (patches, chewing gum).

MAIN OUTCOME MEASURES:

All participants were investigated at the start and after 4 months (medical history, physical examination, laboratory evaluation). Blood samples were drawn for determination of glucose, insulin and C-peptide, both in the fasting state and during an oral glucose tolerance test (OGTT), and for measurement of lipoproteins, fibrinogen, nicotine and cotinine.

RESULTS:

In the intervention group 98 of the subjects (48%) had quit smoking after 4 months. They were compared with the 156 subjects in the control group (91%) who were still daily smokers during the whole period. There were no significant differences in any variable between the two (total) experimental groups at baseline. Plasma nicotine and cotinine decreased (P < 0.001) in the intervention group following smoking cessation, and weight increased by 2.7 kg. In the intervention group HDL-cholesterol increased by 11% (P < 0.001), whereas HbA1c increased by 2% (P < 0.05) only in the control group. No changes occurred in levels of glucose, insulin, C-peptide and fibrinogen.

CONCLUSION:

The smoking cessation programme had a success rate of almost 50% over 4 months. Smoking cessation was associated with a marked increase in HDL-cholesterol levels but did not affect glucose tolerance. A concomitant weight increase may have blunted any independent beneficial effect of smoking cessation on glucose metabolism.

Effects of smoking cessation on insulin and cardio... [J Intern Med. 1996] - PubMed result

This study came to a slightly different conclusion.

Metabolism. 2004 May;53(5):578-82.

Acute effects of nicotine on serum glucose insulin growth hormone and cortisol in healthy smokers.

Morgan TM, Crawford L, Stoller A, Toth D, Yeo KT, Baron JA.


Source

Dartmouth Medical School and Dartmouth-Hitchcock Medical Center, Hannover, NH, USA.


Abstract

Cigarette smoking impairs glucose tolerance and alters serum levels of hormones involved in glucose metabolism, but the role of nicotine in such hormonal alterations is not well understood. In order to isolate the effects of transdermal nicotine on serum glucose, insulin, growth hormone, and cortisol in smokers, we conducted a randomized double-blind placebo-controlled cross-over study involving 34 healthy volunteer smokers between 18 and 55 years of age. Administration of a 14-mg transdermal nicotine patch resulted in nonsignificantly lowered fasting quantitative insulin-sensitivity index (P =.11) and a nonsignificant 9.3-mg/dL mean increase in serum glucose levels during a 75-g oral glucose tolerance test (OGTT) at time 60 minutes (P =.12). There were no substantial differences between groups in the areas under the curve (AUCs) for glucose (P =.33) or insulin (P =.79) during the OGTT. Levels of insulin and cortisol also were not significantly altered by nicotine. A secondary finding observed in the overall study group (primarily in females) was that nicotine caused a 29% median decrease in serum growth hormone (P =.02). We conclude that nicotine patches may lead to mild hyperglycemia and lowered insulin sensitivity. Further research is needed to determine the clinical implications of the unexpected finding that nicotine decreased growth hormone levels in female smokers.

Acute effects of nicotine on serum glucose insulin... [Metabolism. 2004] - PubMed result

The bottom line appears to be that the jury is out. Much as I would hate to develop diabetes, I would rather take my chances with the medications used to treat Diabetes than I would with the radiation and chemo used to treat lung cancer.

 

[JustJulie]

Thank you, Elaine.

 

[Thulium]

Probably true.. After all, nicotine is a highly toxic poison.. I balk at those that compare it to caffeine.

Let's compare. From wikipedia: "The LD50 of nicotine is 50 mg/kg for rats and 3 mg/kg for mice. 40–60 mg (0.5-1.0 mg/kg) can be a lethal dosage for adult humans." verus "The median lethal dose (LD50) given orally, is 192 milligrams per kilogram in rats.[3] The LD50 of caffeine in humans is dependent on weight and individual sensitivity and estimated to be about 150 to 200 milligrams per kilogram of body mass, roughly 80 to 100 cups of coffee for an average adult taken within a limited time frame that is dependent on half-life."

In other words, the amount of caffeine delivered in a single cup of coffee is closer to a toxic dose than the amount of nicotine delivered in a single cigarette.

 

[Vocalek]

It it's 3 mg/kg for mice, and 50 mg/kg for rats, shouldn't the human tolerance be a lot higher? I have known people who smoked as much as 5 packs of cigarettes a day without falling over dead. At 1 mg/cigarette that would be 100 mg of nicotine.

 

[Old Chemist]

It it's 3 mg/kg for mice, and 50 mg/kg for rats, shouldn't the human tolerance be a lot higher? I have known people who smoked as much as 5 packs of cigarettes a day without falling over dead. At 1 mg/cigarette that would be 100 mg of nicotine.

No, no... you must take into account quite fast decay of nicotine molecule in human organism. The half-life is approx. 2 hours. One cannot smoke cigs so fast.

 

[Thulium]

It it's 3 mg/kg for mice, and 50 mg/kg for rats, shouldn't the human tolerance be a lot higher? I have known people who smoked as much as 5 packs of cigarettes a day without falling over dead. At 1 mg/cigarette that would be 100 mg of nicotine.

The key phrase is in the quote about caffeine toxicity: "taken within a limited time frame that is dependent on half-life". A very small amount of a stimulant chemical injected directly into the heart could trigger a lethal heart attack, but out here in the real world where people don't mainline caffeine OR nicotine, poisoning is very rarely serious because unless you somehow injest a very large amount and manage to not puke it all out, under normal conditions most people will simply STOP ingesting recreational stimulants like caffeine and nicotine when they've satisfied their desire LONG before there is any serious risk of overdose.

 

[Kurt]

What is not indicated is the actual amount of the spike. Is it more than, say, just after having a meal? Perhaps the original paper states this.

 

[Kurt]

Interesting. Google Scholar has 2 articles by Xiao-Chuan Liu, XiaoChuan Liu, XC Liu which have anything to do with physiology or biochemistry, and none have to do with nicotine or diabetes biochemistry. I went to the school's website, and he is listed as an Associate Prof, so he has tenure, but he in not full prof. But I cannot find a webpage for his "group".

This was not a paper, it was presented at an American Chemical Society meeting as a talk. There is no paper associated with this study at present, and as such it is not at all peer reviewed. I could get up at an ACS meeting and present my findings that the moon is made of fudge, and the audience would be upset, but there would be a record it was presented. That is all this is at present, and only two articles come up for him from 2000 on, and one is a minor roll in a book chapter on plant transcription. So he is a teaching faculty member only, most likely, not a publishing group, and if he joined the faculty in 2003 (Chemistry Department), which it said in the main directory pdf (but no email) he has not had exactly a stellar publishing career, including for his PhD. I count 2 papers from those years in low-tier journals.

Just to compare Google Scholar, I ran a search on my name, and all but three hits on the first page were my papers in photophysics...and I consider myself to be pretty light in terms of publications compared to established profs. I really hate to sound high and mighty, but this person is not much of a contributor to any field of research.

And yet he is now famous for this unreviewed piece of research which has no paper associated with it. And he has almost zero track record for any research, let alone his own, and let alone in the fields of nicotine or diabetes. California State Polytechnic University is primarily a materials and engineering school, not a fundamental science institute.

OTOH if someone else can find info to contradict this rather scathing assessment, I am all ears. I hope I am wrong, but this is just adding up to Agenda to me.

 

[mwa102464]

I know for a fact it raises my blood sugars, I myself have been doing some personal testing with this, it sucks because I have been using Nic for over 30yrs and I'm type2 diabetic. I have been gradually lowering my Nic as much as possible because of this, kind a sucks because I enjoy the Nic but my health is much more important so lowering I will continue to do until I am at 0MG

 

[Old Chemist]

And he has almost zero track record for any research, let alone his own, and let alone in the fields of nicotine or diabetes. California State Polytechnic University is primarily a materials and engineering school, not a fundamental science institute.

You're absolutely right, Kurt. The man comes out of nowhere and states something that, in fact, requires at least some years of thorough study. I'd also be happy to see some similar research done in an independent lab, specializing in the field of medicine/biochemistry/molecular biology.

There's one thing I wouldn't agree with you - the moon is not made of fudge. It's entirely made of blue cheese. I've done some research on that and I'll publish it in Journal of Useless Research. I will review it myself while sitting on a pier. Then it will be pier reviewed article.

 

[Kurt]

You're absolutely right, Kurt. The man comes out of nowhere and states something that, in fact, requires at least some years of thorough study. I'd also be happy to see some similar research done in an independent lab, specializing in the field of medicine/biochemistry/molecular biology.

There's one thing I wouldn't agree with you - the moon is not made of fudge. It's entirely made of blue cheese. I've done some research on that and I'll publish it in Journal of Useless Research. I will review it myself while sitting on a pier. Then it will be pier reviewed article.

LOL! Very clever. Yeah, I'm not saying this is not a valid experiment or result. I'm just amazed at how the press is jumping on to it before it is even peer reviewed. There is no way to judge the experiment or results. And I thought I had seen several people here stating that vaping did not affect their blood sugar.

 

[DesiG]

One thing that I have noticed about the press is that they seem to not understand the value of peer reviewed research until it bites them where they sit. If they can add weight to the argument that benefits their preset agenda with the words "peer reviewed" or "a majority of experts believe" they will add it, since it sounds impressive. If they want to sell news, they will package the sound bite for the biggest effect.
Just a thought- a couple hundred years ago the majority of learned men (the clergy) insisted that the earth was the center of the universe and the sun went around the earth. Even got one very intelligent scientist to retract his views because all the other 'educated' men thought otherwise. The consensus is not always correct, but the 24/7 news cycle and the agenda driven anti's don't care, and would prefer you not confuse the issue with the facts, thank you.
Happy vaping!

 

[Demarko]

I know for a fact it raises my blood sugars, I myself have been doing some personal testing with this, it sucks because I have been using Nic for over 30yrs and I'm type2 diabetic. I have been gradually lowering my Nic as much as possible because of this, kind a sucks because I enjoy the Nic but my health is much more important so lowering I will continue to do until I am at 0MG

Can you really say it's a fact, though, if you ALWAYS have nicotine in your system? Were you a diabetic before smoking? Can you say with certainty that there are no other factors? Have you gone cold turkey for a few days, and tested your blood sugar? And then start again and have it spike?

Or can you say "It seems possible, in my case." ?

 

[DesiG]

I know for a fact it raises my blood sugars, I myself have been doing some personal testing with this, it sucks because I have been using Nic for over 30yrs and I'm type2 diabetic. I have been gradually lowering my Nic as much as possible because of this, kind a sucks because I enjoy the Nic but my health is much more important so lowering I will continue to do until I am at 0MG

This question is probably a stupid one and please, I mean no offense, but are you making sure to completely wash your hands just prior to checking your BG? Most of my patients just poke themselves, test and occasionally get a really high result because of the (glazed donut!) remains on their fingers Happened to me today when I saw one of my diabetic patients. He figured it out when he licked his finger and it tasted sweet- he got a really funny look on his face and retested after washing his hands (much better results) Anyway the point I was trying to make was this- could it be possible that some of the ejuice is being picked up by your glucometer from your fingers? Now I want to go get mine out of my nursing bag and see if I can get a result using my ejuice, hmm....

 

[Thulium]

This question is probably a stupid one and please, I mean no offense, but are you making sure to completely wash your hands just prior to checking your BG? Most of my patients just poke themselves, test and occasionally get a really high result because of the (glazed donut!) remains on their fingers Happened to me today when I saw one of my diabetic patients. He figured it out when he licked his finger and it tasted sweet- he got a really funny look on his face and retested after washing his hands (much better results) Anyway the point I was trying to make was this- could it be possible that some of the ejuice is being picked up by your glucometer from your fingers? Now I want to go get mine out of my nursing bag and see if I can get a result using my ejuice, hmm....

That is a great point! (pun intended) Even the tiniest layer of glycerin that could be on the finger you're testing could throw off the glucometer quite a bit since most use only a drop or two of blood, it wouldn't take much to skew the results high.

 

[Old Chemist]

And I thought I had seen several people here stating that vaping did not affect their blood sugar.

I'd even say switching to vaping lowered my glucose level a bit, but that's only 2-3%, so it's well withing the experimental error.

This question is probably a stupid one and please, I mean no offense, but are you making sure to completely wash your hands just prior to checking your BG?

This question is absolutely NOT stupid. Many factors can affect those measurements, some of them seem to be stupid ones.

Most of my patients just poke themselves, test and occasionally get a really high result because of the (glazed donut!) remains on their fingers

Now that's really lovely... something like rinsing mouth with some PGA prior to be tested with breathalyser.

Now I want to go get mine out of my nursing bag and see if I can get a result using my ejuice, hmm....

That can be an interesting experiment. Tell us about the results.