TOPLINE: 

Cannabis use was associated with a nearly fourfold increased risk of developing diabetes over a 5-year period, according to an analysis of real-world data from more than 4 million adults.

METHODOLOGY:

• As global cannabis use rises, its long-term metabolic effects remain unclear: Some studies suggest anti-inflammatory or weight-modulating benefits, whereas others raise concerns about glucose metabolism and insulin resistance.
• Researchers conducted a retrospective cohort study using data from 54 healthcare organizations across a global health research network to evaluate the relationship between cannabis use and the risk of developing diabetes.
• They compared 96,795 adults aged 18-50 years (52.9% women) with cannabis-related diagnoses (ranging from occasional use to dependence, including intoxication and withdrawal) between 2010 and 2018 with 4,160,998 healthy control individuals without substance use or major chronic conditions.
• Propensity score matching for age, sex, and baseline comorbidities yielded 86,414 individuals in each cohort.
• The primary outcome was a new diagnosis of diabetes within 5 years of the initial outpatient visit for a cannabis-related diagnosis.

TAKEAWAY:

• The incidence of diabetes was significantly higher among cannabis users (2.2%) than among healthy control individuals (0.6%), with a risk difference of 1.6% (P < .0001).
• Cannabis users had nearly fourfold higher odds of developing diabetes than healthy control individuals (odds ratio, 3.802; 95% CI, 3.449-4.191).
• Further analysis revealed a lower rate of diabetes-free survival among cannabis users (96.82%) than among healthy control individuals (99.15%) over 5 years.

IN PRACTICE:

“As cannabis becomes more widely available and socially accepted, and legalised in various jurisdictions, it is essential to understand its potential health risks,” the lead author noted. 

“These new insights 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,” he added.

SOURCE:

The study was led by Ibrahim Kamel, MD, MHA, Boston Medical Center. It will be presented at the European Association for the Study of Diabetes Annual Meeting in Vienna, September 15-19, 2025. 

LIMITATIONS: 

Because of its retrospective design, the study could not conclude if cannabis use actually caused diabetes. Detailed information on cannabis consumption was absent. Despite propensity score matching, other confounded factors might have influenced results.

DISCLOSURES:

The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.