Before we begin please understand MyCiggy employees are not medically qualified professionals. Any advice we offer is freely available to anyone wishing to research the effects of e-Cigarettes and associated e-Liquids on persons suffering with Diabetes, be it Type 1 or Type 2. If, having done your own research, you are still unsure on the potential side effects of using e-Cigarettes then assistance/guidance from a medical professional familiar with your medical history should be sought. Smoking can and will damage your health; this is an accepted fact regardless of being diabetic or otherwise healthy. Not smoking anything is the best alternative, BUT, if one chooses to continue smoking for what-ever reason, it is generally accepted that smoking e-Cigs is far less harmful than smoking their tobacco equivalents. Traditional cigarettes are harmful for those without diabetes ... for those with diabetes the effects of smoking tobacco based cigarettes can be even more devastating. To determine the effects of e-Cigarettes on the user and we must first understand the Diabetic condition. The blood of a person with diabetes generally carries less oxygen as a result of elevated glucose levels which when combined with mismanaged diabetes treatment increases the risk of losing limbs to amputation. The process of smoking traditional cigarettes creates carbon monoxide which reduces the amount of oxygen in the blood still further. Nicotine has a tendency to constrict blood vessels thereby reducing blood flow to the extremities and increasing the risk of developing gangrene in those parts with the potential for subsequent amputations. Smoking leads to heart disease ... diabetics have a higher risk for heart disease, infections and amputations compared to those without diabetes … and smoking increases these risks still further. Smoking is known to increase the risk of developing cancer and diabetes is known to complicate the healing process, making any cancers even more deadly for those with diabetes. So in short, tobacco based cigarettes are not safe for anyone ... however, if a person already smokes, being diabetic or not, e-cigarettes are considered to be a less damaging alternative and whilst they may contain nicotine they do not generate carbon monoxide nor do they contain the 4600+ chemicals and 50-60 carcinogens found in traditional cigarette smoke. Whilst it is better not to smoke at all, if you feel you must, then e-cigarettes are considered a safer alternative to tobacco based cigarettes. Nicotine is recognised as one of the most detrimental chemicals for Diabetics regardless of its source:- "As a pure drug, nicotine has few adverse effects on physical health; however it does raise blood pressure and accelerates the progression of heart and arterial disease." and "...Upon entering the bloodstream, nicotine immediately stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, respiration, and heart rate. Glucose is released into the blood while nicotine suppresses insulin output from the pancreas, which means that smokers have chronically elevated blood sugar levels...” it has also been stated that “As nicotine is a stimulant, it could increase adrenaline which is associated with releasing energy stored in the liver… but the amounts would be quite small and therefore any rise in blood sugar would be minimal, nothing on the same scale as, say, having a glass of coke or a chocolate bar. If the amount of nicotine is less in an e-cigarette, the rise will be even smaller, even negligible. You will also be getting less of the other toxins associated with smoking tobacco, so an e-Cig would be the better option.” furthermore, as a result of a study carried out in 2000 "some doctors believe nicotine is a positive medical treatment for “some” diabetics. Read that line again, it is a shocking statement for most of us. In 2000, a study performed at Stanford University revealed surprising results about nicotine's effects on blood vessels. Contrary to popular opinion, the study showed that nicotine actually boosts the growth of new blood vessels. The discovery may lead to new treatments for diabetes. Many people with severe diabetes experience poor circulation, which can lead to gangrene and ultimately, limb amputation” (Silverman, 2008). however "For users of products containing nicotine, the news is mostly bad. Nicotine affects the blood vessels negatively in both a short-term and a long-term manner. Nicotine helps to raise the level of LDL cholesterol, which is the "bad" cholesterol. Over time, this will increase the degree to which the linings of the interior walls of blood vessels become coated with plaque. As plaque builds throughout the years, the gradual narrowing of the blood vessels increases the risk of a heart attack. The accumulation of plaque also increases the risk of stroke. Nicotine also causes blood vessels to constrict. The resulting restriction of blood flow through constricted vessels causes an increase in blood pressure and an elevation of the heart rate. The constricting effect of nicotine magnifies the risks presented by plaque accumulation. These damaging effects of nicotine are contributing factors in the statistics indicating that tobacco users are at greater risk of heart attack, stroke and even erectile dysfunction." Still with me so far … Not stopped smoking yet?? That said, we can now address other component parts of e-Liquid being the carriers of both the Nicotine and associated flavourings, generally PG (Propylene Glycol) or VG (Vegetable Glycerine), either singularly or in a percentage combination … (normally expressed PG/VG 70/30 etc.) PG - breaks down into Lactic Acid which has a tendency to make the throat feel dry and, if you are just starting to use e-Cigarettes, can make you feel slightly achy the next day as if you had worked out. Don’t worry you will soon become acclimatised if you are one of the few so affected. VG - breaks down into Glucose in your system which may cause a rise in sugar levels which are, as a matter of course, carefully monitored. If blood sugar levels are seen to rise unacceptably then you may consider switching to a higher PG/VG ratio or a predominantly PG mix. VG is also called "glycerol". Glycerol is one of what are called "sugar alcohols", along with sorbitol, mannitol and several other substances. These sugar alcohols are often used in foods for diabetics because, in theory, they are not supposed to raise blood sugar. There are however several big "but’s” … 1. Sugar alcohols are not supposed to raise blood sugar when eaten, however some people they do suffer with raised blood sugar. The author of the South Beach Diet relates how consuming sugar alcohols can sometimes have a negative effect on weight-loss for some people, even when they aren't eating any other carbs, as a result of their raised blood sugar levels. 2. The other "but" is that whilst in theory glycerol isn't supposed to raise blood sugar for most people when eaten, vaping is "inhaling", not "eating". It is possible that reactions occurring within the gut prevent VG from being fully absorbed into the bloodstream for most people but vaporised VG bypasses the gut and goes straight into the bloodstream and on into liver where it is metabolised. 3. PG has chemical properties similar to glycerol and many argue that PG should be included as a "sugar alcohol", although it is not officially considered a sugar alcohol at the moment. PG does have calories, similar to glycerol and sugar, and is absorbed much the same way. The final part of the e-Liquid is the ‘Flavouring’ which is used to improve the taste of the vapour cloud for the enjoyment of the user; it can be water, oil or alcohol based. It is the latter example which may be of concern to diabetics. That Alcohol turns into sugar is a common misconception. In fact, not only is it impossible for alcohol to turn into sugar in the body, it also tends to lower blood sugar levels. This effect is so well documented that people with diabetes are advised to adjust their insulin and oral medications if they drink alcoholic beverages. Of course, this only refers to straight liquor and wine. The quantity of alcohol in food flavouring forms a very small part of the total mix. The amount can vary dependent upon the flavour type and the strength of the flavour required but rarely would any food flavouring exceed 20% of the total mix, 'normal' ratios may vary between 2-9% or 0.9mg/ml at worst in a 10ml bottle. A ‘standard’ e-Cig 'Clearomiser' holds approximately 1.6ml of e-Liquid, stated to be equivalent to15-20 traditional cigarettes. One full Clearomiser would therefore hold 0.15mg of flavouring alcohol at best, put into perspective the equivalent of drinking 0.25 the volume of a small egg cup of beer each day per 20 cigarette equivalent. So there you have it, Nicotine and VG are not so good for the diabetic condition, PG is ubiquitous, it is used in inhalers, foodstuffs, toiletries etc. and food flavouring has little or no known effect on the user. The good news is that the e-Cig user is not subject to the 4600+ known chemicals and the 50-60 known carcinogens contained within a traditional cigarette. The e-Cig user is also able to control the amount of nicotine intake far more than the traditional cigarette smoker can. Some of our now ‘ex-customers’ found that by reducing the nicotine strength over a period of time helped them to stop smoking altogether when all other attempts to stop smoking had failed. So our advice to you in all cases, diabetic or not, would be ... Stop Smoking … smoking is bad for you and you know it is … but if you choose to continue to smoke, as is your right, then the use of e-Cigarettes with the lowest acceptable nicotine content and the highest PG/VG ratio possible, one that does not spoil your smoking pleasure, is considered the better option. As always, if you are still concerned or unsure please seek professional medical advice before using any form of e-cigarette. Some further reading matter which may be of interest. Best regards and good luck, MyCiggy – the best electronic cigarettes