Welcome back to our weekly diabetes advice tower, Necessitate D'Mine, hosted by veteran type 1 and diabetes author Wil Dubois in NM. Present, you tin ask out all the potentially hard practical questions you may not know WHO to ask.

With the prevalence of new marijuana Pentateuch around the country and the popularity of vaping, we've had an inflow of questions direct to this topic. Now, Wil addresses extraordinary re: smoking shisha and diabetes.

{Got your own questions? Electronic mail us at AskDMine@diabetesmine.com}

Jessica, typewrite 3 from California, asks: Can smoking shisha in a hookah cause the blood glucose to growth? My husband's ancestry clams was never extremely high until he started doing that. Thanks for your reply.

Wil@Ask D'Mine answers: Astonishingly, it just might. And in that respect are trinity factors live that could be the, uh… smoking gun. Sorry. I couldn't resist. But before I poke into those, let's cover about hookah basics for readers WHO may not be familiar spirit with this ancient eastern apparatus.

A hubbly-bubbly is a type of kalian used for smoking flavored tobacco (and sometimes opium or cannabis). Unlike a western tobacco pipage—which is blazing with a match and unbroken burning by the sue of snorting on the pipe—a hookah has a built-in source of combustion in the form of charcoal briquettes situated above the tobacco bowl. Why? I suspect the answer is: The tobacco that's smoked in a shisha differs from the tobacco we usually see in Midwestern pipes. Titled hubble-bubble, it's mix of baccy, molasses, and yield. Keeping dried fruit flaming takes more than the occasional friction match.

Hookahs are oft communal, with many another smoking tubes coming inactive the water tabor pipe like about sort of ornamental devilfish. Hookahs can be used solo or in a group, at home operating theatre in hookah lounges.

As with whatever kind of smoking, the white coating crowd will wail and gnash their un-tobacco-stained dentition, and narrate you the sky is falling. They worry about infectious diseases, because, after all, you're smoking a seed incubator. They worry about toxic chemical exposure from the flavorings. They trouble that, like all smoking, suck happening a hookah will fire your blood squeeze and your heart rate. They worry that smoking causes excitement that can lead to type 2 diabetes. And that you'll be at increased risk for Cancer the Crab.

All true.

Simply what about blood dinero?

The science on that is somewhat pocket-sized. Only I did happen one report that showed a very much stronger association 'tween metabolous syndrome, diabetes, obesity, and dyslipidemia in hookah smokers than in cigarette smokers, suggesting that cigarettes are "better" for your health than hookahs. And no, Duke of Edinburgh Morris and R.J. Reynolds didn't investment firm the study.

Leastwise I father't think they did…

But I digress. Although we seem to live nonexistent in direct literature specifically on the subject of blood sugar levels (as opposed to the to a greater extent general increased risk of diabetes from smoking), I did discover some interesting information on something called "hookah sickness," which is basically a form of carbon monoxide poisoning. This is a job unique to hookahs among tobacco-smoking options, and is caused by the burning charcoal briquettes that inflame the flavored tobacco in the shisha. Few jolly cool research showed that while nicotine levels for totally smoking products are about the same, folks using tralatitious hookahs exhale 9 to 10 multiplication more CO compared to cigs surgery electronically heated hookahs.

Now the riveting set off is how carbon monoxide gas intoxication whole kit, happening an anatomic level—whether the source equal a nargileh or a hose from the tailpipe of a car.  Apparently, carbon monoxide binds to hemoglobin to form carboxyhemoglobin, which reduces oxygen to the brain. So I have to wonder, if carbon monoxide binds to hemoglobin, is it a far-off stretch to think that the C monoxide in hookah smoke might have a blood sugar effect? I don't bed. We know on that point is a human relationship between Hb and glucose. A before and after fingerstick would be an interesting try out.

Speechmaking of nicotine, which I mentioned in passing just a minute ago, did you know that nicotine triggers the release of glucose from the colorful? Information technology does. In a slam-dunk cogitation, California Polytechnic scientist Xiao-Chuan Liu, PH.D., was fit to isolate nicotine as the root cause of smoky's long-recognized sugar-raising effect. His search shows that nicotine throne bump A1C aside a whopping 34%.

For perspective, if your A1C were, say 7.5, increasing it aside 34% turns it into a 10-plus.

Ouch.

Meanwhile, discussions connected the personal effects of hookah smoking and blood sugar surface quite frequently in internet discourse boards, with quite a bit of argument as to whether hookahs get up profligate sugar, and if they do, how would they do so? On the far side the nicotine and the CO we already discussed, I came across a really interesting idea at the community board Hookah Lounge. There, a guest poster called MrMister theorized that perhaps the glucose in the yield and molasses in the shisha mightiness represent the culprit. That's an stimulating thought.

Let's think up about that. Forward the hookah smoker inhaled rather than puffed, and most do, atomic number 3 the water bowl cools the smoke, anything carried in the green goddess volition travel from the lungs into the bloodstream. Chop-chop. Clearly, shisha smoke contains vaporized glucose. But does volatilised glucose still act care sugar? Based on how glycerol vaporization acts, I think we stool constitute pretty confident that information technology would; but whether there's adequate glucose in the smoke to give a detectable difference, I posterior't say. The like anything else having to do with carbs, I suppose IT would turn on how much you smoked, and how responsive to sugar you are. Motionless, most PWDs will see a bump in their blood sugar if they eat flush a tiny bit of fruit without a bolus. Something to ponder while you puff.

Meanwhile, huffing sugar mightiness be an interesting alternative to glucagon for some small startup to investigate. Hey, if you can inspire small-grained insulin and lower your blood glucose, wherefore non inspire powdered glucose and raise information technology? Just please don't render this at internal with the left-over powdered sugar from holiday baking.

Back to hookahs and blood glucose: For your husband, the proof was in the hookah bowl. He started puffing and his moolah went high. Looking at the skill, there are at least three possible causes, and perhaps information technology's a combination of all three. So, yeah, I dismiss see that, for him, leastwise, the smoking is raising his sugar.

So now what? Does he need to quit? Not necessarily, although given all the other health effects of smoking, quitting might be a sensible Newfound Year's resolution. Still, I'm non in the business of telling others how to live their lives. I will enounce this, however: Anything that you do—either healthy or bad for you—that raises your origin sugar demands that you make a exchange. That vary could beryllium to discontinue, or that change could equal to increase your diabetes medications.

Either agency.

Only going your blood glucose "extremely high" isn't an option.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. Bottom Job: You still need the counselling and tending of a commissioned medical professional.