Bad news: cannabis associated with 80% higher risk of DKA!

This JAMA letter discusses the association between self-reported cannabis use and DKA (diabetic ketoacidosis):

To read the full article, you need to sign up for a free account—or you can read the summary on WebMD:

The letter’s data is based on self-reporting statistics of DKA patients. It establishes no causality between the two—although I could see that heavy use might impair the sound judgment required at all times to make insulin dosage choices. But I can see other issues, such as different A1c average and socio-economic level (as reported in the WebMD summary), that could be responsible for at least some, if not all of the difference in DKA rates.

This seems highly likely to be a case of an unmodeled third variable link—people with lower motivation for tight control over their health and life perhaps, or people who have avoidant coping strategies for dealing with stress being both more likely to both end up in DKA and use MJ, for example.


There may also be some drug interactions that affect metabolism. My husband was going to try some CBD oil for inflammation but it turns out that it is not recommended in conjunction with some meds he is already taking.

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Speaking for “a friend” :wink:

I’ve heard, back in the day, someone who takes to smoking “medicinal” marijuana all the time is probably suffering from one of the inevitable side effects:

The Munchies! :rofl:

But in all seriousness, from what I understand, one of the immediate side effects is lowering blood sugar, which causes appetite increase, and is one of the reasons this plant is so effective in certain treatments.

I think that it is safe to say that over consumption of anything is a bad idea, and that consuming too many carbs after getting high all the time would possibly be the cause here?

Really seems like a biased study then!


@michel I saw this one and wrote it off as a bit of “shock science” and correlation NOT causation.

Given that Mary Jane has just been legalized in Canada and it can now even be purchased online from the government with convenient home delivery, there may be some better research going on in this area.

Terribly sorry - not going to be the guinea pig for you on this one :slight_smile: :guinea_pig:

EDIT: Given that cannabis (we are now using the latin name in Canada apparently to perhaps make it sound better?) was illegal until recently, I think most people with the good A1Cs were probably not reporting to their doctor about there cannabis use for fear of prosecution :slight_smile:

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I agree also! If you read the WebMD report, the authors themselves were already identifying two control variables that they were not compensating for: A1c and income (and we know income is correlated with different therapeutic outcomes). I probably did not express my own thoughts on the topic sharply enough :slight_smile: :

Searching for more info, I found this in a cdc article, noting increased DKA since 2009.

DKA hospitalizations in the United States have increased among all age groups, with the highest rates among persons aged <45 years. Although the continued decline in in-hospital DKA mortality is encouraging, further work might help identify populations at risk. Evidence-based, targeted prevention measures, such as diabetes self-management education and support might help reverse the trend in this potentially life-threatening but avoidable complication of diabetes.

My emphasis on bolding. I think the higher cost of insulin should be in there too, as possible factor.