B Rasouli1, T Andersson1,2, P-O Carlsson3, V Grill4,5, L Groop6, M Martinell7, K Midthjell8, P Storm6, T Tuomi9, S Carlsson1. 1. Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 2. Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden. 3. Department of Medical Sciences, Uppsala University, Uppsala, Sweden. 4. NTNU Institute of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway. 5. Department of Endocrinology, Trondheim University Hospital, Trondheim, Norway. 6. Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden. 7. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. 8. HUNT Research Centre, Department of Community Medicine and General Practice, Norwegian University of Science and Technology, Levanger, Norway. 9. Department of Medicine, Helsinki University Central Hospital and Research Program for Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
Abstract
AIMS: It has been suggested that moist snuff (snus), a smokeless tobacco product that is high in nicotine and widespread in Scandinavia, increases the risk of Type 2 diabetes. Previous studies are however few, contradictory and, with regard to autoimmune diabetes, lacking. Our aim was to study the association between snus use and the risk of Type 2 diabetes and latent autoimmune diabetes of adulthood (LADA). METHOD: Analyses were based on incident cases (Type 2 diabetes, n = 724; LADA, n = 200) and population-based controls (n = 699) from a Swedish case-control study. Additional analyses were performed on cross-sectional data from the Norwegian HUNT study (n = 21 473) with 829 prevalent cases of Type 2 diabetes. Odds ratios (OR) were estimated adjusted for age, BMI family history of diabetes and smoking. Only men were included. RESULTS: No association between snus use and Type 2 diabetes or LADA was seen in the Swedish data. For Type 2 diabetes, the OR for > 10 box-years was 1.00 [95% confidence interval (CI), 0.47 to 2.11] and for LADA 1.01 (95% CI, 0.45 to 2.29). Similarly, in HUNT, the OR for Type 2 diabetes in ever-users was estimated at 0.91 (95% CI, 0.75 to 1.10) and in heavy users at 0.92 (95% CI, 0.46 to 1.83). CONCLUSION: The risk of Type 2 diabetes and LADA is unrelated to the use of snus, despite its high nicotine content. This opens the possibility of the increased risk of Type 2 diabetes seen in smokers may not be attributed to nicotine, but to other substances in tobacco smoke.
AIMS: It has been suggested that moist snuff (snus), a smokeless tobacco product that is high in nicotine and widespread in Scandinavia, increases the risk of Type 2 diabetes. Previous studies are however few, contradictory and, with regard to autoimmune diabetes, lacking. Our aim was to study the association between snus use and the risk of Type 2 diabetes and latent autoimmune diabetes of adulthood (LADA). METHOD: Analyses were based on incident cases (Type 2 diabetes, n = 724; LADA, n = 200) and population-based controls (n = 699) from a Swedish case-control study. Additional analyses were performed on cross-sectional data from the Norwegian HUNT study (n = 21 473) with 829 prevalent cases of Type 2 diabetes. Odds ratios (OR) were estimated adjusted for age, BMI family history of diabetes and smoking. Only men were included. RESULTS: No association between snus use and Type 2 diabetes or LADA was seen in the Swedish data. For Type 2 diabetes, the OR for > 10 box-years was 1.00 [95% confidence interval (CI), 0.47 to 2.11] and for LADA 1.01 (95% CI, 0.45 to 2.29). Similarly, in HUNT, the OR for Type 2 diabetes in ever-users was estimated at 0.91 (95% CI, 0.75 to 1.10) and in heavy users at 0.92 (95% CI, 0.46 to 1.83). CONCLUSION: The risk of Type 2 diabetes and LADA is unrelated to the use of snus, despite its high nicotine content. This opens the possibility of the increased risk of Type 2 diabetes seen in smokers may not be attributed to nicotine, but to other substances in tobacco smoke.
Authors: Jessica Edstorp; Yuxia Wei; Emma Ahlqvist; Lars Alfredsson; Valdemar Grill; Leif Groop; Bahareh Rasouli; Elin P Sørgjerd; Per M Thorsby; Tiinamaija Tuomi; Bjørn O Åsvold; Sofia Carlsson Journal: Diabetologia Date: 2022-07-28 Impact factor: 10.460
Authors: Magdalena Niegowska; Alessandro Delitala; Giovanni Mario Pes; Giuseppe Delitala; Leonardo A Sechi Journal: PLoS One Date: 2017-05-04 Impact factor: 3.240