There has been a significant increase in the use of cannabis among adults with diabetes in the United States despite the drug’s unclear impacts on health outcomes, according to recent data published in the journal Diabetes Care.1 The authors said that the findings support the use of screening and education about potential risks.
Cannabis use in the US is now prevalent and increasing due to many states legalizing medical and recreational use.2 Adults with diabetes are no exception, despite a potential increased risk of diabetic ketoacidosis and negative impacts on metabolic factors.3,4 However, despite some research pointing to adverse effects, the impact of cannabis use in patients with diabetes is not well understood.
Key Takeaways
- Cannabis use among adults with diabetes in the US increased by 33.7% from 2021 to 2022, with 9% of diabetic adults using cannabis in the past month.
- Cannabis use in diabetic patients may pose risks such as diabetic ketoacidosis and adverse metabolic effects, although comprehensive research on these impacts is limited.
- Healthcare providers should discuss the potential harms of cannabis use with diabetic patients, emphasizing the importance of screening and education about the risks associated with cannabis and other psychoactive substances.
“The increased use of cannabis in the US for managing health-related symptoms has led to its increased use among individuals with chronic diseases, including millions of people with diabetes,” the authors wrote. “However, due to the difficulties of conducting studies with cannabis, including the number of cannabinoids and various routes of administration, as well as federal restrictions, there is limited research on its effect on glucose metabolism, lipid profiles, and cardiovascular risk for people with diabetes.”
READ MORE: Children with T1D at Increased Risk of Psychiatric Disorders Later in Life
Investigators from the University of California San Diego School of Medicine conducted a study to estimate the most recent national prevalence of cannabis use among adults with diabetes and delineate characteristics. Data for the study was gathered from the 2021 to 2022 National Survey on Drug Use and Health, which is conducted by the Substance Abuse and Mental Health Services Administration.
The study cohort included 6816 adults with a lifetime diagnosis of diabetes. Patients who reported cannabis use were compared to those who reported not using it. Cannabis use within the past month was gauged by asking about the use of cannabis products that are smoked, vaped, dabbed, ate, drank or applied via a lotion. CBD and hemp products were excluded. Covariates included sociodemographic characteristics, past-year all-cause emergency department (ED) use, past-year major depression, past-month misuse of opioids and/or stimulants, and binge drinking.
Investigators found that 9% of adults with diabetes were estimated to have used cannabis in the past month. From 2021 to 2022, the prevalence of users increased by 33.7%, rising from 7.7% to 10.3%. Over 48% of people with diabetes who reported using cannabis in the last month were under the age of 50.
Additionally, factors associated with higher-odds of using cannabis in the past month included living in a state where cannabis is legal, having a history of hepatitis, experiencing a major depressive episode in the last year, as well as using tobacco, binge drinking, or misusing opioids in the last month.
Study limitations include that the data did not distinguish between diabetes type or type of cannabis product used, a reliance on self-reporting, and that samples were only gathered from the noninstitutionalized population.
“[C]linicians must discuss with their patients with diabetes the potential harms of cannabis use on diabetes-related outcomes without a clear understanding of its benefits,” the authors concluded.” Further, screening for and education about the potential risks of its use and other psychoactive substances must be done with all patients with diabetes and discussed in the context of managing and monitoring their diabetes.”
READ MORE: Diabetes Resource Center
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References
1. Han BH, Pettus JH, Yang KH, et al. Past-Month Cannabis Use Among Adults With Diabetes in the U.S., 2021–2022. Diabetes Care. 2024; dc240597. https://doi.org/10.2337/dc24-0597
2. Lapham GT, Matson TE, Bobb JF, et al. Prevalence of Cannabis Use Disorder and Reasons for Use Among Adults in a US State Where Recreational Cannabis Use Is Legal. JAMA Netw Open. 2023;6(8):e2328934. doi:10.1001/jamanetworkopen.2023.28934
3. Kinney GL, Akturk HK, Taylor DD, et al. Cannabis Use Is Associated With Increased Risk for Diabetic Ketoacidosis in Adults With Type 1 Diabetes: Findings From the T1D Exchange Clinic Registry. Diabetes Care 1 January 2020; 43 (1): 247–249. https://doi.org/10.2337/dc19-0365
4. Porr CJ, Rios P, Bajaj HS, et al. The effects of recreational cannabis use on glycemic outcomes and self-management behaviours in people with type 1 and type 2 diabetes: a rapid review. Syst Rev. 2020 Aug 17;9(1):187. doi: 10.1186/s13643-020-01411-9. PMID: 32807222; PMCID: PMC7433109.
