In people with type 1 diabetes, older age, longer diabetes duration, female sex, lower A1C, and diabetic neuropathy favor a diagnosis of gastroparesis over cannabis hyperemesis syndrome.
Endocrinologists, gastroenterologists, emergency medicine physicians
Older age and neuropathy favor gastroparesis; younger age favors CHS
What the researchers found
The study identified clinical features that help differentiate diabetic gastroparesis (DG) from cannabinoid hyperemesis syndrome (CHS) in people with type 1 diabetes, two conditions with substantially overlapping presentations of nausea, vomiting, and abdominal pain. Older age, longer diabetes duration, female sex, lower A1C, and presence of diabetic neuropathy were indicators favoring DG over CHS.
Why it matters
Cannabis hyperemesis and diabetic gastroparesis present nearly identically, and misdiagnosis in either direction leads to inappropriate treatment. As cannabis use increases among people with diabetes, clinicians need practical tools to tell these conditions apart.
The numbers in context
Differentiating factors: older age, longer diabetes duration, female sex, lower A1C, and diabetic neuropathy favor gastroparesis over CHS
How the study worked
Clinical comparison study of people with type 1 diabetes presenting with symptoms consistent with either diabetic gastroparesis or cannabis hyperemesis syndrome. Specific sample size and study design details limited in the brief report format.
What this study cannot tell us
Brief clinical report with limited sample size details. Retrospective identification of differentiating factors may not fully capture the complexity of clinical presentations. Does not address cases where both conditions may co-occur.
How to read the evidence
Brief clinical report provides useful practical guidance but lacks detailed methodology and sample size information, limiting confidence in the specificity of differentiating features.
When this study was published
2025 publication
The bigger picture
Cannabis hyperemesis syndrome has become increasingly recognized as cannabis use rises, but its overlap with common gastrointestinal conditions creates diagnostic challenges. This is especially relevant in populations with pre-existing GI conditions like diabetic gastroparesis.
Questions still open
- How often is CHS misdiagnosed as diabetic gastroparesis in clinical practice? Could a validated screening tool incorporating these clinical features improve diagnostic accuracy?
Common questions
Why is it hard to tell these conditions apart?
What clues point toward cannabis hyperemesis instead of gastroparesis?
Read the original research
Differentiating Diabetic Gastroparesis and Cannabis Hyperemesis Syndrome in People With Type 1 Diabetes.
Clinical diabetes : a publication of the American Diabetes Association, 43(3), 416-419
Citation
Akturk, Halis Kaan; Mason, Emma; Snell-Bergeon, Janet; Shah, Viral N; Karakus, Kagan Ege. (2025). Differentiating Diabetic Gastroparesis and Cannabis Hyperemesis Syndrome in People With Type 1 Diabetes.. Clinical diabetes : a publication of the American Diabetes Association, 43(3), 416-419. https://doi.org/10.2337/cd24-0096