Cannabis legalization for medical and recreational uses has increased, driven by the more permissive attitudes towards cannabis. Potential beneficial effects of cannabinoids have been reported in studies of diabetic retinopathy and neuropathy. Higher prevalence of diabetic ketoacidosis, however, was reported in type 1 diabetes patients who use cannabis. Whether cannabis use has changed over time among patients with diabetes is unknown. Here, we estimate the prevalence of cannabis use among participants with diabetes in the National Survey on Drug Use and Health (NSDUH, 2005-2017), a large nationally representative sample of the United States non-institutionalized population aged 12 years and older. Audio computer-assisted self-interview system (ACASI) assessed cannabis use in the participant residence. During the ACASI, participants were asked whether a doctor or health care professional had ever told them that they had diabetes. The number of NSDUH participants with diabetes ranged from 1537 (weighted % = 6.7) in 2005 to 2919 (9.3%) in 2017. The prevalence of past 30-day cannabis use among diabetes patients was 1.7% (95% CI = 1.1, 2.6) in 2005, increasing to 4.8% (95% CI = 3.8, 6.0) in 2017. Similarly, past 12-month use has increased from 2005 to 2017. This increasing trend is observed across age, sex, ethnic self-identification and education subgroups, and in states with or without medical cannabis laws.
In summary, cannabis use has increased ∼180% in NSDUH participants with diabetes from 2005 to 2017. Physicians should educate patients on cannabis use, including its effects on appetite and gastric emptying, and its effect on perception and treatment adherence, which can be crucial in insulin-dependent diabetes. Additional research is also needed to understand the effect of cannabis on glucose metabolism and diabetes complications.
O. Alshaarawy: None.
National Center of Complementary and Integrative Health (R00AT009156); Michigan State University
