Medical researchers have long known that diabetics who smoke are compounding their health risks and very possibly shortening their lives. What had remained a mystery was the specific culprit that lurked in a pack of cigarettes.
Two teacher-scholars at Cal Poly Pomona appear to have found the answer: nicotine. The addictive chemical is widely considered the leading suspect, but scientific progress rests on research, the kind that Sean Liu and John Chan meticulously perform in the lab they share on campus. Though they caution that their results are preliminary, it appears they have opened a new window to the way doctors and patients assess diabetes risks among smokers.
Liu, an associate professor of chemistry, is an expert in A1C, more commonly known as glycated hemoglobin. (A higher blood sugar level is typically associated with a higher A1C level.) Chan, a professor of biology, studies nicotine. With offices just down the hall from each other, they frequently talk shop, but it took a casual conversation over lunch in the Campus Center Marketplace to forge a research partnership.
¿We talked about the possibility that nicotine could affect A1C levels,¿ Liu says. ¿Afterward, we went to the [scientific] literature and couldn¿t find anything. That¿swhen we decided to collaborate.¿
Looking back, Chan says with a smile, had he and Liu not grabbed a bite to eat that afternoon two years ago, ¿this wouldn¿t have happened.¿
¿This¿ has taken place over many months in a nondescript laboratory on the third floor of the biotechnology building. In layman¿s terms, their research involves meticulously following a basic recipe, altering the amount of one ingredient and then assessing the results.
¿We put human blood cells in a solution to release the hemoglobin and then we added metabolized blood sugar: glucose-6-phosphate,¿ Liu says. ¿We added various amounts of nicotine and checked the A1C level.¿
The process initially sounds complex, but Chan and Liu explain it in a way that even a scientifically challenged observer can grasp. First, they create a gel that acts as a magnet for A1C. They put the gel in a test tube (called a column tube) and add a solution containing released hemoglobin from human blood cells exposed to glucose-6-phosphate and various amounts of nicotine. Through a process called elution, the A1C can be collected. The A1C is then transferred to a small, light-transparent container called a cuvette. The cuvette is placed in a spectrophotometer, whose readings show how much the A1C fluctuates.
The implications could be significant. People who smoke but have no familial disposition to diabetes might raise their risks through their consumption of nicotine. Those who decide to quit smoking by weaning themselves with nicotine patches could still experience greater A1C levels. Long-term use of patches, then, might continue to expose the user to a higher risk of diabetes.
After hearing about the research, ¿doctors were initially surprised but they saw that it made sense,¿ Liu says. ¿In the long term, this research could influence how diligently doctors screen their diabetic patients.¿
Liu and Chan both caution that they are working with preliminary results in a laboratory setting and that more concrete data beyond their initial findings are required. The next step, Chan says, is to examine whether similar observations can be reproduced in studies on animals. Once confirmed, the mechanism of how nicotine induces more A1C in the presence of glucose at a chemical and molecular level can be examined.
¿We need to do more study,¿ Chan says.
The research was supported with residual funds from previous grants, a grant from the Faculty Center for Professional Development and assistance from the College of Science. Chan and Liu say they need outside support to complete and publish their findings.
¿We don¿t need a lot,¿ Chan says. ¿We believe this could be significant.¿