Researchers surveyed 932 adults with type 1 diabetes about alcohol,
smoking and substance use. They assigned each person a cannabis use
score ranging from 0 for no use at all to 33 for the highest
exposure to the drug.
Most participants - 871 - had little or no risk from cannabis
exposure, with cannabis use scores of 0 to 3. Another 61 people were
considered to have moderate risk from cannabis exposure, with
cannabis use scores of 4 to 26.
Compared to low-risk individuals, people with moderate risk were 2.5
times more likely to experience ketoacidosis, a serious complication
of diabetes that develops when blood sugar is elevated for too long
and the body produces high levels of acids known as ketones. Left
untreated, ketoacidosis can lead to severe dehydration, swelling in
the brain, coma and death.
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"Cannabis is a known addictive substance, and this potentially
problematic aspect of cannabis use should be assessed in patients
with type 1 diabetes," study leader Gregory Kinney of the Colorado
School of Public Health, University of Colorado Anschutz Medical
Campus in Aurora and colleagues write.
Cannabis is the most commonly used illicit drug in the U.S., and
recent legislation has made cannabis legal for either medical or
recreational use in more than half of states, Kinney and colleagues
note in Diabetes Care.
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In a separate paper published recently in JAMA Internal Medicine,
researchers involved in the current study reported similar findings,
but only in patients from a single medical center in Colorado, where
medical and recreational cannabis use is legal. The current study
involved diabetes patients at 69 sites.
Moderate risk cannabis users in the current study tended to be
younger, and more of them were male, compared to people who rarely
if ever used the drug.
Moderate-risk individuals also had less education on average, had
been diagnosed with type 1 diabetes at a younger age, and had poorer
control of their blood sugar levels than people who rarely, if ever
used the drug.
One limitation of the current study is that researchers relied on
participants to accurately report any cannabis use, even when they
lived in states where the drug is illegal. Researchers also lacked
data on how well patients managed their diabetes or followed
prescribed insulin treatment regiments.
Some previous research suggests that for people with type 2 diabetes
- the more common form linked to obesity - cannabis may make it
easier to maintain lower blood sugar levels. But less is known about
the impact of cannabis on people like those in this study, who had
type 1 diabetes, the less common form that typically develops in
childhood and is caused by a breakdown in the body's immune system.
SOURCE: http://bit.ly/2Ox0xc4 Diabetes Care, online October 18,
2019.
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