People with type 1 diabetes are more likely to develop deadly complications when they consume cannabis. This emerges from a recent study.
The researchers surveyed 450 patients with type 1 diabetes in Colorado, where cannabis is legal for use in medicine and recreation. Overall, 30 percent of the participants used cannabis.
Compared to non-users, cannabis users were about twice as likely to suffer from a major complication known as diabetic ketoacidosis. This occurs when the blood sugar is raised too long and the body produces high acids called ketones.
Without treatment, ketoacidosis can lead to severe dehydration, swelling in the brain, coma and death.
Compared to non-users, cannabis users were about twice as likely to suffer from a major complication known as diabetic ketoacidosis. This resulted in a study of 450 patients in Colorado
Some previous research indicates that cannabis in people with type 2 diabetes, the most common form associated with obesity, may facilitate the use of the hormone insulin to convert food into energy and maintain lower blood sugar levels, she said the researchers in JAMA Internal Medicine.
Less is known about the effects of cannabis on people with type 1 diabetes, the less common form that typically develops in childhood and is caused by a collapse of the body's immune system.
The study was not a controlled experiment to determine if and how cannabis could cause ketoacidosis directly.
However, it is possible that vomiting, caused by long-term use of cannabis, can lead to dehydration, increase ketones, and lead to ketoacidosis in people with type 1 diabetes. Viral Shah from the Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus in Aurora.
"Elevated ketones can be life-threatening if not treated in time, and patients may experience nausea, vomiting, abdominal pain, respiratory distress, and rarely confusion or impaired consciousness," Shah said.
"Diabetic ketoacidosis is an emergency and patients with diabetes should go to the ER 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.
Study participants typically had poorly controlled diabetes, based on blood tests of hemoglobin A1c (HbA1c), which reflect average blood glucose levels over about three months.
People with type 1 diabetes are generally advised to keep their HbA1c levels below 6.5 percent.
Participants taking cannabis in the study had average A1c levels of 8.4 percent, which is a dangerously high blood sugar that may increase the risk of heart attacks, strokes, kidney failure, blindness, amputations and death.
Non-cannabis users had mean A1c levels of 7.6 percent, still above the ideal level, but not as dangerous as the levels for people who consumed marijuana.
Further research is needed to understand the different effects of cannabis on people with different types of diabetes, Dr. Annemarie Hennessy, Dean of the School of Medicine at Western Sydney University in Australia.
"Type 1 does not produce insulin, and type 2 does not work well," said Hennessy, who was not involved in the study.
Patients should still be careful and avoid cannabis, advised Hennessy.
"Why cannabis increases the likelihood of diabetic ketoacidosis is unknown," Hennessy said.
"But we have also shown that diabetic ketoacidosis is more difficult to diagnose in the presence of cannabis and can therefore be missed with fatal consequences."