Cannabis use is linked to ketoacidosis in type 1 diabetes

  • Kinney GL & al.
  • Diabetes Care
  • 18 Oct 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • An association has been found between cannabis use and increased risk for diabetic ketoacidosis (DKA) in adults with type 1 diabetes (T1D).

Why this matters

  • Cannabis-induced alterations to gut motility, food absorption, and postprandial glycaemic timing may be unexpected and inconsistent for cannabis users with T1D.

Study design

  • Total substance score for cannabis (TSC) and DKA in past 12 months assessed in 932 adults in the T1D Exchange.
  • Participants classified by recommended intervention: low risk/none (TSC 0-3; n=871); moderate risk/brief (4-26; n=61); and high risk/intensive (>26; n=0).
  • Funding: Helmsley Charitable Trust.

Key results

  • Compared with no intervention, factors tied to classification by moderate risk/brief intervention included: being male and younger at T1D diagnosis, having less education and higher HbA1c, and being less likely to use continuous glucose or fingerstick monitoring and more likely to use tobacco/other substances.
  • No differences in race, insulin pump use, severe hypoglycemia requiring hospitalisation, or alcohol use.
  • DKA was associated with a TSC >4 (OR, 2.5; 95% CI, 1.0-5.9) adjusted for sex, age at study visit, and HbA1c.
  • Adjustment for legal status of cannabis in state of residence did not alter this association.

Limitations

  • Cannabis use self-reported.
  • Cross-sectional design.
  • Lack of details about diabetes self-management, adherence.