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Study population Among participants who underwent the health screening examination between 2009 and 2012 we identified 2,746,079 individuals with DM as follows: (1) fasting plasma glucose 126 mg/dL at the health screening or (2) a previous history of DM which was defined as International Classification of Disease (ICD)-10 code (E1114) diagnosis with at least one claim per year for the prescription of antidiabetic agents before the health screening

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Paq5000 DNA polymerase (Agilent Technologies, Santa Clara, CA, USA) was used for amplification from swab samples, and 5% dimethyl sulfoxide (DMSO) was added to the reaction to improve the concentration of the amplified products from the metagenomic template

_ Cigarette smoking: One cigarette usually takes about 5 to 7 minutes