People with type 1 diabetes may be more likely to develop potentially fatal complications when they use cannabis, a recent study suggests. Researchers surveyed 450 patients with type 1 diabetes in Colorado, where cannabis is legal for medical and recreational use.

Overall, 30% of the participants used cannabis. The study was published in JAMA Internal Medicine.

Compared to nonusers, cannabis users had about twice the risk of experiencing a serious complication known as diabetic ketoacidosis, which develops when blood sugar is elevated for too long and the body produces high levels of acids known as ketones.

Left untreated, ketoacidosis can lead to severe dehydration, swelling in the brain, coma, and death. Some previous research suggests that for people with type 2 diabetes the more common form linked to obesity cannabis may make it easier to use the hormone insulin to convert foods into energy and maintain lower blood sugar levels.

But less is known about the impact of cannabis on people with type 1 diabetes, the less common form that typically develops in childhood and is caused by a breakdown in the body’s immune system.

Ketoacidosis

The study wasn’t a controlled experiment designed to prove whether or how cannabis might directly cause ketoacidosis. But it’s possible that vomiting caused by long-term cannabis use might lead to dehydration that can increase ketones and lead to ketoacidosis in people with type 1 diabetes.

Elevated ketones may be life-threatening if not treated on time, and patients can (have) nausea, vomiting, abdominal pain, shortness of breath and rarely confusion or altered consciousness.

Diabetic ketoacidosis is an emergency and patient with diabetes should go to an emergency room if they have symptoms. The condition is typically treated with intravenous fluids to hydrate the body and replenish electrolytes and insulin to control blood sugar.