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(Reuters Health) – A recent study suggests that people with type 1 diabetes are more likely to develop life-threatening complications when they use cannabis.
The researchers interviewed 450 patients with type 1 diabetes in Colorado, where cannabis is legal for medical and recreational use. In total, 30% of participants used cannabis.
Compared to non-users, cannabis users were about twice as likely to suffer from a serious complication called diabetic ketoacidosis, which develops when blood glucose levels are too high and the body produces high levels of blood sugar. Acids called ketones. Untreated ketoacidosis can lead to severe dehydration, swelling of the brain, coma and death.
Some research suggests that for people with type 2 diabetes – the most common form linked to obesity – cannabis could facilitate the use of hormonal insulin to convert food into energy and maintain lower blood sugar, noted researchers in JAMA Internal Medicine. But less is known about the impact of cannabis on people with type 1 diabetes, the less common form that typically develops during childhood and is caused by a failure of the body's immune system.
The study was not a controlled experiment designed to prove whether cannabis could directly cause ketoacidosis or how. But it is possible that vomiting caused by long-term cannabis use leads to dehydration that can increase ketone levels and lead to ketoacidosis in people with type 1 diabetes, said Dr. Viral Shah , lead author of the study, Barbara Davis Center for Diabetes of the University of Toronto. Colorado Anschutz Medical Campus in Aurora.
"High ketones can be life-threatening if not treated in time, and patients may experience nausea, vomiting, abdominal pain, shortness of breath, and rarely confusion or altered consciousness," he said. said Shah by email. "Diabetic ketoacidosis is an emergency and the diabetic patient should go to emergency if he has symptoms."
The disease is usually treated with intravenous fluids to moisturize the body and replenish electrolytes and insulin to control blood sugar.
Study participants generally had poorly controlled diabetes, based on blood tests for hemoglobin A1c (HbA1c), which reflected average blood glucose levels over a period of about three months. It is generally advisable for people with type 1 diabetes to keep their HbA1c level below 6.5%.
Participants who used cannabis during the study had an average blood glucose value of 8.4% A1c, which represents a dangerously high blood sugar level that may increase the risk of heart attacks, strokes, failure kidney, blindness, amputations and deaths.
Non-cannabis users had mean A1C readings of 7.6%, which is still better than ideal but not as dangerous as marijuana users.
Additional research is needed to understand the different impact of cannabis on people with different types of diabetes, said Dr. Annemarie Hennessy, Dean of Medicine at Western Sydney University in Australia.
"In type 1, individuals do not make insulin and in type 2, it usually does not work well," said Hennessy, who was not involved in the study, by e-mail.
Patients should still be cautious and avoid cannabis, Hennessy advised.
"Why would cannabis increase the risk of diabetic ketoacidosis ?," said Hennessy. "But we have also shown that in the presence of cannabis, diabetic ketoacidosis is more difficult to diagnose and may therefore be missed, with fatal consequences."
SOURCE: bit.ly/2SNqw07 JAMA Internal Medicine, online November 5, 2018.
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