A patient with type 1 diabetes was treated for diabetic ketoacidosis six times in one year before clinicians discovered that cannabinoid hyperemesis syndrome from undisclosed cannabis use was triggering the repeated episodes.
Clinicians managing diabetic emergencies and cannabis users with diabetes
6 DKA episodes in 1 year
What the researchers found
The patient experienced 6 DKA episodes in one year with persistent GI symptoms even after DKA resolved. Unusual lab findings (unexpectedly high pH and bicarbonate levels) eventually prompted screening for illicit drug use, revealing cannabis use and leading to a diagnosis of cannabinoid hyperemesis syndrome (CHS). The vomiting from CHS caused dehydration and poor insulin absorption, triggering repeated ketoacidosis.
Why it matters
Cannabinoid hyperemesis syndrome can masquerade as a diabetic emergency, leading to repeated hospitalizations and delayed diagnosis. In patients with type 1 diabetes, the vomiting from CHS creates a dangerous cycle of dehydration and ketoacidosis.
The numbers in context
6 DKA episodes in 1 year; persistent GI symptoms after DKA resolution; unusually high pH and bicarbonate for ketoacidosis; diagnosis of CHS upon drug screening
How the study worked
Single case report documenting a type 1 diabetes patient with 6 DKA episodes over one year. Chart review of laboratory findings, clinical course, and eventual diagnosis.
What this study cannot tell us
Single case report cannot establish frequency of CHS-triggered DKA. Patient may have had other contributing factors. The diagnosis of CHS itself relies on clinical criteria after excluding other causes. No follow-up data on outcomes after cannabis cessation.
How to read the evidence
Single case report highlighting a diagnostic pitfall, but cannot quantify how common this presentation is
When this study was published
2023 study
The bigger picture
As cannabis use increases, clinicians need to consider CHS in diabetic patients with recurrent DKA, especially when presentations are atypical. Routine screening for cannabis use in patients with unexplained recurrent DKA could prevent repeated hospitalizations.
Questions still open
- How common is CHS among people with type 1 diabetes? Would routine cannabis screening in recurrent DKA reduce hospitalizations? Does cannabis use affect insulin sensitivity independently of CHS?
Common questions
Can cannabis use cause diabetic emergencies?
What is cannabinoid hyperemesis syndrome?
Read the original research
Unexpected cause of recurrent diabetic ketoacidosis in type 1 diabetes: a case report.
BMC endocrine disorders, 23(1), 137
Citation
Alduraibi, Rabia Khalid; Altowayan, Yosef Fahad; AlMharwal, Bader Tha'ar. (2023). Unexpected cause of recurrent diabetic ketoacidosis in type 1 diabetes: a case report.. BMC endocrine disorders, 23(1), 137. https://doi.org/10.1186/s12902-023-01394-3
Explore the wider topic
- Surviving 4/20 Sober: A Practical Survival Guide
- CBD Oil Quality Guide: How to Avoid Snake Oil
- CBT for Cannabis Recovery: How Cognitive Behavioral Therapy Works
- Anxiety After Quitting Weed: When to Consider Medication
- Cannabis for Chemotherapy Nausea: What the Evidence Actually Shows
- Cannabis for Chronic Pain: What the Research Actually Supports
- Cannabis and Epilepsy: The Epidiolex Story and What It Means
- The Cannabis Relapse Cycle: Quit, Feel Good, Get Complacent, Repeat
- Does CBD Actually Work for Anxiety? What the Evidence Shows
- Does CBD Help with Weed Withdrawal? What Studies Show
- CBD vs THC: The Differences That Actually Matter
- Cold Turkey vs Tapering: Which Way to Quit Weed
- Dating Sober After Years of Being High: What Nobody Tells You
- Exercise as Medicine: Working Out After Quitting Weed
- Grieving Weed Itself: Mourning the Loss of a Companion
- How to Help Someone Quit Weed (When They're Not Ready)
- How to Quit Weed: A No-Judgment Step by Step Guide
- Journaling Through Weed Withdrawal: Why Writing Helps You Heal
- MA vs SMART Recovery vs Therapy: Comparing Your Options
- The Proven Medical Benefits of Cannabis: What Research Supports
- Meditation and Mindfulness for Weed Withdrawal
- Your Partner Still Smokes Weed: How to Navigate It
- Quitting Weed While Your Partner Still Smokes
- The Pink Cloud Effect: When Quitting Weed Feels Too Good
- How to Quit Smoking Weed Cold Turkey: What to Expect
- Quit Weed or Cut Back: Which Is Right for You?
- I Quit Weed and Regret It: An Honest Look at Non-Linear Recovery
- Quitting Weed in Your 20s: Career, Social Life, Starting Over
- Quitting Weed in Your 30s: It's Not Too Late
- Quitting Weed After 10+ Years of Daily Use: What to Expect
- Quitting Weed Before Surgery
- Quitting Weed During a Life Crisis: Divorce, Job Loss, and Other Bad Timing
- Quitting Weed and Working Out: How Exercise Helps Recovery
- Quitting Weed After Loss: When Grief Comes Flooding Back
- Quitting Weed When It's Legal Everywhere
- Weed and Medications: What Changes When You Quit
- Quitting Weed During Pregnancy: What You Need to Know
- Quitting Weed While Pregnant: What You Need to Know
- Weed Withdrawal Success Stories: Real People Who Made It Through
- Quitting Weed Long Distance: When You Can't Remove Triggers
- I Relapsed on Weed. Now What? A Practical Reset Guide
- I Relapsed After Quitting Weed: What Now?
- Cannabis and Older Adults: Risks Seniors Should Know
- Should I Quit Weed? A Decision Framework (Not a Lecture)
- Quitting Weed at Music Festivals and Concerts: A Sober Survival Guide
- Supplements That Actually Help with Weed Withdrawal (And Ones That Don't)
- How to Tell Your Friends You're Quitting Weed
- Cannabis and Breastfeeding: THC in Breast Milk
- Relapse Prevention Plan for Cannabis: A CBT-Based Approach
- Why Weed Relapse Happens: The Science Behind Going Back
- Replacing the Ritual: What to Do When You Quit Weed
- How Cannabis Damaged My Relationships: Before and After
- Social Media Detox from Weed Content