Type 1 diabetes

Cannabis use linked to higher DKA risk in type 1 diabetes

People with type 1 diabetes who use cannabis are at an almost doubled risk of being hospitalised for diabetic ketoacidosis within the past year compared to non-users, a survey shows.

The findings are concerning given that 30% of adults with type 1 diabetes ireported using cannabis in the previous year, say the study authors from the University of Colorado in Aurora in a letter published in JAMA Internal Medicine.

The survey involving 450 participants found that 20% of the self-reported cannabis users were hospitalised with DKA within the previous year compared to 8.2% of non-users (OR 1.98).

Participants who reported cannabis use  also had higher mean HbA1C levels [ 8.4% vs 7.6%) compared with non-users after adjusting for confounders. Cannabis users had a mean 0.41% higher HbA1c level than non users when adjusted for insulin delivery method, income and age.

However, there was no difference in severe hypoglycaemia (20.3% vs 15.6%) between cannabis users and non-users with type 1 diabetes.

“Cannabinoids alter gut motility and cause hyperemesis which may play a role in increased risk for DKA in type 1 diabetes,” the study authors suggested.

They noted that the study was limited by its self-reporting nature and unmeasured confounders such as access to healthcare could not be ruled out.

More research was needed confirm their findings and understand the adverse consequences of cannabis use in this population, they said.

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