A new study suggests that both current and former e-cigarette users have an elevated risk of developing prediabetes, even if they have never smoked traditional cigarettes. The study, published in the American Journal of Preventive Medicine, analyzed data from a survey of over 600,000 U.S. adults about their smoking and vaping habits. Participants were also asked if they had ever been told by a healthcare provider that they had prediabetes or 'borderline diabetes,' which is slightly elevated blood sugar that isn't yet full-blown type 2 diabetes but increases the likelihood of developing it. The study found that roughly 9 percent of both current and former e-cigarette users had prediabetes. Compared to people who never vaped, the risk of prediabetes was 22 percent higher for current e-cigarette users and 12 percent greater for former vapers. Among people who never smoked traditional cigarettes, current vaping was associated with 54 percent higher odds of developing prediabetes. The study's senior author, Shyam Biswal, PhD, noted that these findings are surprising because e-cigarettes are often considered a safer alternative to traditional smoking. According to the Centers for Disease Control and Prevention (CDC), more than 1 in 3 American adults have prediabetes. This condition occurs when the body can't properly use insulin to convert food into energy, causing blood sugar levels to rise over time. Prediabetes increases the risk of developing type 2 diabetes, heart attacks, and strokes. Various blood tests can determine if blood sugar levels are slightly above normal (indicating prediabetes) or high enough to be classified as type 2 diabetes. One common test measures average blood sugar levels over two to three months by assessing a type of hemoglobin that binds to glucose in the blood, known as A1C. A1C levels between 5.7 percent and 6.4 percent indicate prediabetes, while levels of 6.5 percent and higher point to type 2 diabetes. However, one limitation of the study is that it relied on survey responses rather than blood test data to identify individuals with prediabetes. Researchers also lacked data on the types of cigarettes or e-cigarettes used, frequency of use, and the amount of nicotine or other chemicals participants were exposed to. Patricia Folan, a certified tobacco treatment specialist, noted that the way individuals use vape products might also contribute to the risk of developing diabetes. Unlike smokers who often take breaks between cigarettes, vapers tend to use e-cigarettes continuously throughout the day, which could increase the risk of prediabetes and other health issues. Brian Oliver, a professor at the Woolcock Institute of Medical Research, emphasized that there is no safe e-cigarette, as all components can have detrimental effects on the body.