Cannabis use is associated with a nearly fourfold greater chance of developing diabetes, according to an analysis of data from more than 4 million adults. The results are being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Vienna, Austria.
Cannabis use is increasing worldwide. In 2021, there were an estimated 219 million users (4.3% of the adult population). Despite this widespread use, little is known about its effects on metabolism.
Earlier research showed possible benefits, such as anti-inflammatory effects and support for weight management. Other studies pointed to potential drawbacks, such as disruption of glucose regulation and insulin resistance. The actual magnitude of diabetes risk remained unclear.
Analysis of Large Patient Data
To find stronger evidence, Dr. Ibrahim Kamel from Boston Medical Center in Massachusetts and his team analyzed electronic medical records from 54 healthcare facilities within the TriNetX Research Network, with locations in the US and Europe.
They identified 96,795 patients (ages 18 to 50, 52.5% female) who received a diagnosis related to cannabis between 2010 and 2018. This ranged from occasional use to dependence, and also included intoxication or withdrawal symptoms.
For comparison, the researchers matched this group to 4,160,998 individuals with no substance use or serious chronic diseases. Age, gender, and baseline health status were taken into account. All participants were followed for five years.
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In total, the researchers examined data from 4,160,998 adults with no substance use or major chronic diseases.
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This was the control group, against which the smaller group of 96,795 cannabis users was compared.
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All participants (totaling more than 4.2 million people) were followed for five years.
The figures visible in the diagrams (2.2% vs. 0.6%) come from these two groups:
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In the cannabis group: 1,937 new cases (2.2%).
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In the control group: 518 new cases (0.6%).
Nearly Fourfold Risk After Adjustments
After adjusting for HDL and LDL cholesterol, untreated high blood pressure, cardiovascular disease, cocaine use, alcohol use, and other risk factors, the researchers found that new cases of diabetes were significantly more common in the cannabis group (1,937; 2.2%) than in the control group (518; 0.6%). The analysis showed that users were nearly four times more likely to develop diabetes than non-users.
According to the authors, additional research is needed to understand the relationship between cannabis and diabetes. Possible explanations include insulin resistance and unhealthy eating patterns. Nevertheless, the results already have implications for medical monitoring and public health messaging.
Public Health Implications and Warnings
“As cannabis becomes more widely available and socially accepted, and is legalized in more countries, it is important to understand the potential health risks,” said lead author Dr. Kamel.
“These new insights from real-world data show how important it is to consider diabetes risk in the treatment and management of substance use. It is also necessary for healthcare providers to discuss cannabis more frequently with patients, so they better understand their risk and know whether additional monitoring is needed.”
The researchers note that more research is needed on the long-term effects of cannabis and whether the diabetes risk applies primarily to smoked products or also to other forms, such as edibles.
Despite the important findings, this is a retrospective study, which means it cannot prove that cannabis use causes diabetes. It also cannot be ruled out that other factors influenced the results, despite efforts to limit bias using statistical methods.
The study had limitations, such as the lack of precise data on usage and possible errors in classification. The authors point out that real-world data is often incomplete due to inaccurate patient records.
Disclaimer: There is a risk of bias due to inaccurate measurement of use and because participants had to self-report their use, even in countries where cannabis was illegal.
Verified Sources
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- Meeting: Annual meeting of the European Association for the Study of Diabetes e.V. (EASD)
- With thanks to SciTechDaily
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Frequently Asked Questions
What exactly does this research say about cannabis and diabetes?
The study shows that people who use cannabis are nearly four times more likely to develop diabetes within five years. This conclusion is based on data from over 4.2 million people.
How reliable are these figures?
While the sample size is large, this is a retrospective analysis. There is therefore no direct proof of a cause-and-effect relationship, but the association is statistically compelling enough to take seriously.
Do these risks apply to all forms of cannabis use?
That is not yet clear. The study does not distinguish between forms of use, such as smoking or eating, so further research is needed on this.
Are there other possible explanations?
The researchers mention insulin resistance, eating habits, and lifestyle as possible factors. It remains difficult to determine exactly what portion of the risk is directly related to cannabis use.
What can healthcare providers do with this information?
Healthcare providers can more frequently include cannabis use in risk assessments for metabolic diseases. Early screening or lifestyle advice can then be better tailored to individual needs.
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