Vaping and use of e-cigarettes has largely been a trend of youth since their introduction several years ago. Now new research shows that when young people attempt to stop using these products they are largely failing to do so. Michael Blaha, an anti-smoking advocate and cardiologist at Johns Hopkins, comments.

Blaha: It’s very interesting that the amount of unsuccessful quit attempts from nicotine have actually increased recently. That’s largely driven by people unsuccessfully trying to quit vaping, and we know very little about quitting vaping. There’s very few clinical guidelines, there’s no FDA approved medications per se, and there’s very little guidance for teachers or parents on how to talk to particularly young people about how to quit nicotine.  :29

Blaha says nicotine addiction is almost uniformly challenging to overcome, and there are no studies to inform the characteristics of the addiction in younger people versus those who’ve used nicotine for prolonged periods. At Johns Hopkins, I’m Elizabeth Tracey.


When the diabetes medicine metformin is taken by men in the three months prior to conception of sons, it may increase the risk for genital and urinary tract malformations three and a half times, a Danish study finds. Rita Kalyani, a diabetes expert at Johns Hopkins, says while attention has been focused on the health of prospective mothers for some time, it may be time to look at fathers also.

Kalyani: I think this study certainly gives us pause to think about investigating the impact of medication use in the father, whether it’s metformin, other diabetes drugs or drugs in general, on spermatogenesis. The finding that the birth defects in this study were only seen in boys does suggest that there probably is some mechanism related to sex hormones. This was an observational study, it does have limitations, and I do think we need better prospective studies to look at this question.  :30

At Johns Hopkins, I’m Elizabeth Tracey.


Men who used the diabetes medicine metformin during the three months prior to conception of their son saw malformations of the genital and urinary tracts three and a half times more often in these children, a very large study from Denmark finds. Johns Hopkins diabetes expert Rita Kalyani explains.

Kalyani: What they found was that in this observational study they went back and looked at the use of metformin in fathers and related it to whether their children had birth defects and what they found is that actually there was an increased risk of birth defects in boys born to fathers that used metformin in a formative period, three months before they were conceived.  :26

Kalyani says metformin is recommended as first line treatment for type 2 diabetes and is therefore used quite commonly, so finding out more about this association will be very important. She notes that there are quite a few choices in diabetes medicines that might be used alternatively. At Johns Hopkins, I’m Elizabeth Tracey.


In the year following a Covid-19 infection, some 40% of adults in one study developed new onset type 2 diabetes. Rita Kalyani, a diabetes expert at Johns Hopkins, says certain populations were much more at risk for this outcome.

Kalyani: Older adults, over the age of 65, Black versus white, those with prediabetes, and those who were obese, were more likely to develop diabetes. These were all people who might have been on the edge. Had risk factors for developing diabetes but hadn’t developed it yet, and then with Covid-19 developed the full blown onset of the disease. Forty percent increased risk is a lot, what this study doesn’t yet answer is will these people have long lasting diabetes, or will it resolve over time.  :31

Kalyani says it may be possible to reverse the condition over time as inflammation decreases, as well as employing diet and exercise strategies to improve blood sugar levels. At Johns Hopkins, I’m Elizabeth Tracey.


People who’ve had Covid-19 have a 40% higher risk for developing type 2 diabetes in the year after their infection, a new study finds. Johns Hopkins diabetes expert Rita Kalyani says there may be a couple of reasons for this.

Kalyani: This had been reported. There’s been different mechanisms suggested for how Covid-19 can increase the risk for diabetes. Not only by increasing inflammation in the body but perhaps some direct effects on the beta cells in the pancreas that produce insulin, and impacting insulin production. But this study was particularly interesting because we have the extended follow up now almost a year after the Covid-19 infection and also they found that people used medications for diabetes more often as well if they had Covid-19 versus not.  :31

Kalyani says the medication use indicates that medication was needed to control the condition, rather than diet and exercise strategies alone. At Johns Hopkins, I’m Elizabeth Tracey.


So-called long Covid may now include a new diagnosis of diabetes, a recent study shows. Diabetes expert Rita Kalyani at Johns Hopkins says this study follows participants over 12 months after their Covid infection.

Kalyani: It was really in a national database. Almost 200,000 participants who had a positive Covid-19 test between March 2020 when the pandemic started, and September 30, 2021. So now we have the benefit of extended follow up time that we didn’t have earlier in the pandemic. And what they found was that there was a 40% increased risk of developing new onset diabetes with Covid-19 infection in the year after someone had developed Covid-19.  :29

Kalyani notes that people who’ve had Covid-19 might want to be aware of symptoms of diabetes in the year after infection, including increased thirst and more frequent urination. If such symptoms develop a follow up with your primary care physician is a good idea. At Johns Hopkins, I’m Elizabeth Tracey.


Autoimmune diseases, where the body’s immune system attacks parts of the body, are common. Now the UK Biobank study finds that such conditions also increase someone’s risk to develop cancer. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, reviews the data.

Nelson: Overall, that is about a six to eight percent increased risk for cancer in the setting of these autoimmune diseases. They did look at things that we already knew a lot about. The risk for cancer in a particular organ that is affected by the autoimmune disease so things like ulcerative colitis has been known forever to have an association with colorectal cancer. If you look at people who had an immune related diseases in this cohort they were more likely to smoke, have a higher body mass index, have lower physical activity, eat processed meats and other foods, have a low education level, all of which are associated with an increased risk for cancer.  :32

Nelson says the exact mechanism whereby autoimmunity promotes cancer isn’t known, but says for now following screening recommendations is a good idea. At Johns Hopkins, I’m Elizabeth Tracey.