Vaping and Prediabetes: What the Research Really Shows

Recent population studies have found that adults who vape are significantly more likely to develop prediabetes, even when controlling for weight, age, and activity level. In one major U.S. study, vapers had a 40% higher risk compared to non-users.

This is the first clear evidence that e-cigarettes may not only affect the lungs — but also metabolic health.

What’s driving this link?

Even without traditional cigarette smoke, vaping still exposes the body to chemicals, nicotine, and inflammatory compounds that alter glucose metabolism.

✔ Nicotine Increases Insulin Resistance

Nicotine raises stress hormones like cortisol and adrenaline.
That makes it harder for your cells to use insulin effectively — a direct path toward prediabetes.

✔ Inflammation Increases in the Body

Vape aerosols contain small particles and chemicals that cause low-grade inflammation.
Chronic inflammation is strongly linked to both insulin resistance and the development of type 2 diabetes.

✔ Blood Vessel Function Declines

Vaping damages the lining of blood vessels (endothelium), raising cardiovascular and metabolic risk.

✔ Oxidative Stress Rises

This disrupts normal cellular function, including how your body processes glucose.

✔ Appetite and Eating Patterns May Shift

Nicotine suppresses appetite temporarily, leading some people to eat irregularly — which destabilizes blood sugar.

Together, these effects create the perfect storm for metabolic dysfunction.

For many people, yes — even if fasting blood sugar appears normal, insulin levels often rise behind the scenes.
This early insulin resistance can go unnoticed for years before creeping into:

• prediabetes

• full diabetes

• cardiovascular complications

That’s why screening is so important for vaping users, especially those with a family history of diabetes.

Probably — but not by much.

Traditional smoking is strongly linked to diabetes. Vaping appears to carry similar metabolic risks, just through different pathways. The problem is not only nicotine — it’s inflammation, particle exposure, and endocrine disruption from vape aerosols.

For people with:

• PCOS

• obesity

• insulin resistance

• family history of diabetes

• gestational diabetes history

vaping may worsen underlying vulnerabilities.

You may want to get screened if you notice:

• increased thirst

• fatigue after meals

• sugar cravings

• unexplained weight changes

• brain fog

• slow wound healing

• frequent infections

These symptoms can appear before blood sugar becomes elevated.

Small changes make a big difference:

• Cut back gradually instead of quitting abruptly

• Avoid high-nicotine cartridges

• Increase movement to reduce insulin resistance

• Eat protein-forward meals

• Stay hydrated

• Get yearly A1C labs

• Seek medical support if trying to quit

Your metabolic health can improve quickly once exposure decreases.

If you’re worried about your vaping habits or your blood sugar, CallOnDoc can support you by:

• ordering A1C or metabolic labs

• evaluating symptoms related to insulin resistance

• helping create a nicotine-reduction or quit plan

• managing weight, cravings, or underlying anxiety

• offering follow-up support as your body adjusts

Your health goals don’t require perfection — just the first step.