Cannabis Tied to Serious Type 1 Diabetes Complications, Study Finds

People with Type 1 diabetes may be more likely to develop potentially fatal complications when they use marijuana, according to a new study.

Authors of the study, which has been published on the JAMA Network, said they have found “recurrent diabetic ketoacidosis (DKA) with cannabis use in patients with Type 1 diabetes (T1D).”

Diabetic ketoacidosis develops when blood sugar is elevated for too long and the body produces high levels of acids known as ketones.

Ketoacidosis can lead to severe dehydration, swelling in the brain, coma, and death.

Senior study author Dr. Viral Shah of the Barbara Davis Center for Diabetes at the University of Colorado told Reuters that vomiting caused by long-term cannabis use might lead to dehydration. This, in turn, could cause an increase in ketones, leading to ketoacidosis in people with Type 1 diabetes.

“Elevated ketones may be life-threatening if not treated on time, and patients can [have] nausea, vomiting, abdominal pain, shortness of breath, and rarely confusion or altered consciousness,” Shah said, according to the report. “Diabetic ketoacidosis is an emergency and patients with diabetes should go to the emergency room if they have symptoms.”

The condition is typically treated with intravenous fluids to hydrate the body and replenish electrolytes and insulin to control blood sugar.

According to the study, 450 patients with Type 1 diabetes were evaluated in Colorado, where cannabis is legal for medical and recreational use.

“Cannabis use is increasing with the shifts in legality and public perceptions in the United States,” the authors of the study noted.

They pointed to the existence of prior research indicating potentially higher insulin sensitivity and improved pancreatic beta cell function with cannabis use, making it easier for patients with Type 2 diabetes to maintain lower blood sugar levels.

But they added that the effect of cannabis use on patients with Type 1 diabetes, which is less common than Type 2, had not been properly studied.

According to Reuters, the JAMA Network study was not a controlled experiment designed to prove whether or how cannabis might directly cause ketoacidosis.

Marijuana And Diabetes

Overall, 30 percent of the participants in the study used cannabis. Their blood tests showed they had poorly controlled diabetes.

People with Type 1 diabetes are generally advised to keep their hemoglobin levels below 6.5 percent, but the cannabis users in the study had average readings of 8.4 percent. This was said to represent dangerously elevated blood sugar that can increase the risk of heart attacks, strokes, kidney failure, blindness, amputations, and death.

The non-cannabis users in the study had average hemoglobin readings of 7.6 percent. This is higher than the advised threshold, but less dangerous than found in those study participants who used marijuana.

Dr. Annemarie Hennessy, dean of the School of Medicine at Western Sydney University in Australia, said that more research is needed to understand the impact of marijuana on diabetics.

“In Type 1, individuals don’t make insulin and in Type 2, it mostly doesn’t work well,” Hennessy, who wasn’t involved in the study, said by email, according to Reuters.

However, she advised diabetes patients to err on the side of caution and avoid using marijuana.

“Why cannabis would increase the likelihood of diabetic ketoacidosis is unknown,” Hennessy said. “But we have also shown that in the presence of cannabis, the diabetic ketoacidosis is harder to diagnose, and therefore it may be missed, with deadly consequences.”