VAPING AND YOUTH DIABETES SURGE: “WE THOUGHT THINGS WOULD NORMALIZE”, RESEARCHER SAYS
Over the study period of surging diabetes, vaping of nicotine – linked causally directly to diabetes – had started at earlier ages, for more days, and more intensely
by Clark Miller
Published February 23, 2024
The study covered two years, and the study subjects were male and female adolescents.
CHICAGO — An increase in pediatric type 2 diabetes cases that began during school closures amid the COVID-19 pandemic has not returned to baseline, according to a retrospective study.
Compared with the year before COVID emerged, the number of new pediatric type 2 diabetes cases ballooned during the first year of the pandemic (March 2020 through February 2021; P=0.005), and then jumped again during the second year (March 2021 through February 2022; P=0.0006), reported Esther Bell-Sambataro, MD, of Nationwide Children’s Hospital and the Ohio State University in Columbus, during ENDO 2023, the annual meeting of the Endocrine Society.
“Even though we may have returned to pre-pandemic times in several aspects, the increased risk of our youth developing type 2 diabetes that started during the pandemic appears to have persisted in the second year of the pandemic,” she said.
This was the opposite finding of what the researchers hypothesized when they initiated this chart review at their institution.
The researchers believed they would see an increase in the first year of the COVID pandemic, due to school shutdowns causing kids to be less active, snacking more often, and eating more unhealthy foods.
“During the pandemic, we did see quite a bit of really decreased physical activity,” Bell-Sambataro told MedPageToday. “Kids were out of school. Oftentimes, breakfast and lunch – meals that they have at school which now are being provided at home – might not have been as nutritious or as well-balanced.”
“And so, we expected that once they returned back to school, things would normalize, which is not what we found,” she added. . . .
Throughout the study, the children were about 12 years old at diagnosis.
Huh! That is puzzling, but not for anyone paying attention to diabetes risk factors for the age group of “about 12 years old”.
That age is included in the age group of adolescents found over those study period years to have experienced dramatic rises in initiation of vaping of nicotine, at earlier ages, and more intensely – more days per month and increasingly starting vaping after waking in the morning, an indicator of compulsive use, or “dependence”.
Let’s take a look at that.
But first, there’s another contributing risk factor not included in the original JAMA report. The concentration of nicotine – a chemical directly affecting insulin resistance and linked to onset and worsening of prediabetes and diabetes – in preparations used in vape devices is typically many times more concentrated what would provide an amount of nicotine per inhalation comparable to that provided by traditional combustible tobacco cigarettes. The dosing is much higher.
In 2022, over 2.5 million middle and high school students reported using e-cigarettes, according to the National Youth Tobacco Survey, with nearly half (46%) of high schoolers who vape doing so near daily, putting them on a trajectory for a potential lifetime of nicotine addiction.
As e-cigarettes have expanded to include a diverse array of flavors and device types, nicotine strengths have been climbing. The average nicotine concentration in e-cigarette products increased from 2.10% to 4.34% between 2013 and 2018 alone, a 106.7% increase. The popular JUUL devices were originally introduced in 2015 with a 5% nicotine salt pod, prompting JUUL competitors to begin offering nicotine salt concentrations as high as 7% in what has been called a “nicotine arms race.”
Back to the original JAMA research report, in which the 151,573 youth respondents were “US students in grades 6 to 12” that is ages approximately 11 to 18, over years including the period of the diabetes study, 2014 to 2021.
Let’s take a look.
Mean age of first vape use clearly shifted over the period of the diabetes study downward, toward the approximate age 12 of that study.
Take a look at Figure 3. Shift to “heavier use” of e-cigarettes was especially evident over the years of the otherwise unexplained youth diabetes surge.
The study concluded –
This survey study found that between 2014 and 2021, although prevalence of e-cigarette use among adolescents peaked in 2019 and then declined, the age of initiation among ever users continued to decrease and the intensity of use and level of addiction among adolescents who are current e-cigarette users increased. This increasing intensity of use may reflect the higher nicotine delivery and addiction liability of e-cigarettes that use protonated nicotine.1,2
There is nothing surprising about the troubling surge in youth diabetes, or the correspondence with trends of nicotine use in youth.
Is it time to pay attention?
