A major study of more than four million people has found that using cannabis quadruples the risk of developing type 2 diabetes.
An estimated 4.3% of adults worldwide use cannabis and while there is some evidence that it may feature anti-inflammatory or weight management properties, there are fears around its impact on glucose metabolism and insulin resistance.
Until now, the link between cannabis use and diabetes has been unclear.
Lead author Dr Ibrahim Kamel, from the Boston Medical Center, said: “As cannabis becomes more widely available and socially accepted, and legalised in various jurisdictions, it is essential to understand its potential health risks.
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“These new sights from reliable real-world evidence highlight the importance of integrating diabetes risk awareness into substance use disorder treatment and counselling, as well as the need for healthcare professional to routinely talk to patients about cannabis use so that they can understand their overall diabetes risk and potential need for metabolic monitoring.”
The study saw researchers examine health records spanning Europe and the USA to identify just over 96,000 people with cannabis-related diagnoses.
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They were matched with just over 4.1m similar but healthy individuals with no record of substance use, with follow up at five years.
After controlling for a number of factors, the research team found a 2.2% increase in the number of new cases of diabetes in the cannabis group, compared to 0.6% in the healthy group.
The team says the endocrine effects of using cannabis needs to be investigated further, along with whether the form of cannabis – inhaled or edible – impacts on diabetes risk.