Moderate cannabis use increases risk for diabetic ketoacidosis among adults with type 1 diabetes
Adults with type 1 diabetes who use cannabis products are more than twice as likely to develop diabetic ketoacidosis as those who do not use cannabis products, according to findings published in Diabetes Care.
“Cannabis is a known addictive substance, and this potentially problematic aspect of cannabis use should be assessed in patients with type 1 diabetes,” Gregory L. Kinney, MPH, PhD, an assistant professor at the Colorado School of Public Health of the University of Colorado Anschutz Medical Campus in Aurora, and colleagues wrote. “Providers should discuss with their patients who use cannabis the possibility of altered glycemic control, cannabis hyperemesis syndrome and diabetic ketoacidosis.”
Kinney and colleagues conducted a cross-sectional study with 932 adults from the T1D Exchange clinic registry. Participants self-reported their cannabis habits on a 33-point scale via the Alcohol, Smoking and Substance Involvement Screening Test. The researchers defined a score between 4 and 26 as moderate cannabis dependency risk and a score of more than 26 as high cannabis dependency risk and collected data on diabetic ketoacidosis that required hospital visits from participants.
There were 61 participants who met the threshold for at least moderate cannabis dependency risk (mean age, 31 years; 45.9% women) and 871 participants who were considered nonusers (mean age, 38.2 years; 62.1% women). The researchers noted that the average HbA1c among those with at least moderate cannabis dependency risk was 8.4% compared with an average HbA1c of 7.7% among nonusers (P = .005) and that type 1 diabetes was diagnosed at an average age of 12.8 years among those with at least moderate cannabis dependency risk and at an average age of 16.1 years among nonusers (P = .007). The researchers also found that adults with at least moderate cannabis dependency risk were 2.5 times more likely to develop diabetic ketoacidosis compared with nonusers (OR = 2.5; 95% CI, 1-5.9) and that “adjustment for the legal status of cannabis in the state of residence did not alter this association.”
“We hypothesize that unpredictable gastric dysmotility and severity of gastroparesis among cannabis users with cannabis hyperemesis syndrome may result in suboptimal glycemic control,” the researchers wrote. “Moreover, cannabis-induced increase in appetite may result in increased glycemic excursions, and users may experience higher overnight glucose and an altered perception of hypoglycemia because of cannabis impairing their ability to manage diabetes.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.