It looks like people with Type 1 diabetes may have to keep their hands off cannabis. Why? A recent study suggests that Type 1 diabetes patients who use cannabis are more likely to suffer from potentially fatal complications.
The study was published in JAMA Internal Medicine.
How the study was conducted
The study was conducted in Colorado, which has legalized cannabis both for medical and recreational purposes. It involved 450 participants with Type 1 diabetes — 30 percent of whom used cannabis.
The study found that compared to people who do not smoke pot, those who do had about double the risk of developing a serious complication. This complication is called diabetic ketoacidosis, which happens when the patient’s blood sugar is elevated for too long and their body creates high levels of acids that are known as ketones.
When diabetic ketoacidosis is left untreated, it can result to severe dehydration, brain swelling, coma, and even death.
Moreover, the participants typically had poorly controlled diabetes as shown in their blood tests of hemoglobin A1c(HbA1c), reflecting average blood sugar levels over around three months. Generally, people with Type 1 diabetes are advised to keep their HbA1c levels under 6.5 percent.
While non-cannabis user participants had average A1c readings of 7.6 percent, those who consumed pot had of 8.4 percent. This number represents dangerously elevated blood sugar, which in turn can increase the risks of heart attacks, kidney failure, strokes, amputations, blindness, and death.
What do previous studies say?
Some earlier research suggests that for Type 2 diabetes patients, cannabis may make it easier for them to use insulin in order to convert food into energy, as well as to maintain lower blood sugar levels. However, less was known about the drug’s impact on people with Type 1 diabetes.
Type 1 is the less common form of the disease. Typically, it develops in childhood and is caused by immune system breakdown.
Not a controlled experiment
The study was not a controlled experiment that was designed to find out how cannabis might directly cause ketoacidosis. This is one of the study’s limitations.
According to lead author Dr. Viral Shah of the Barbara Davis Center for Diabetes at the University of Colorado Anschutz Medical Campus in Aurora, it is possible that vomiting caused by long-term cannabis consumption could lead to dehydration, which can increase ketones and result to ketoacidosis in Type 1 diabetes patients.
Shah said that elevated ketones could be life-threatening if it is not addressed on time and the patients can suffer from vomiting, nausea, abdominal pain, altered consciousness, and shortness of breath. She pointed out that diabetic ketoacidosis is an emergency situation and diabetic patients should rush to emergency if they manifest the symptoms.
The condition is usually treated with intravenous fluids in order to prevent dehydration and to replenish electrolytes as well as insulin to control the blood sugar.
More research is needed
Aside from the study not being a controlled experiment, the authors also acknowledged that their findings depended on the self-reported diabetes outcomes.
According to Dr. Annemarie Hennessy of the School of Medicine at Western Sydney University of Australia, more research is necessary in order to understand the various impact of cannabis on patients with different types of diabetes.
She also noted that the possibility of unmeasured confounders, including access to health care, should not be excluded.
Patients, she said, should avoid cannabis and err on the side of caution.