A little more than a decade after Colorado and Washington became the first U.S. states to legalize marijuana for recreational purposes, 54% of Americans live in a state where recreational use of the drug is legal, according to a 2024 report from the Pew Research Center. The same report further cites that 79% of Americans live in a county with at least one cannabis dispensary.

As the use of cannabis for recreational and medical purposes continues to rise, health professionals must be aware of the potential effects on patients’ health. During a Monday, June 24, Ask the Expert session, a panel of investigators will discuss The Highs and Lows of Cannabis Use in Diabetes—Behavioral and Psychosocial Considerations. The session will be held at 3:15 p.m. ET in Room W314 of the Orange County Convention Center.

Angela Bryan, PhD, Professor of Psychology and Neuroscience, University of Colorado Boulder, will present for the first time primary data from a National Institutes of Health (NIH)-funded study she led to analyze the associations between different types of common cannabinoids and health factors, such as diet, physical activity, and metabolic indicators, including insulin function and inflammation.

“Most of the interesting findings came from the comparisons between cannabis users and non-cannabis users,” Dr. Bryan explained. “Once a person becomes a regular cannabis user, it seems there are some advantages in terms of inflammatory profile, along with some minor advantages in terms of healthy eating and physical activity.”

Dr. Bryan emphasized the importance of leaving preconceived notions about cannabis use out of the research process.

“It’s important that we think agnostically about the use of cannabis products,” she said. “Often, people either have the notion that cannabis will create a hellscape anywhere it is legalized or that it is some miracle drug that will cure everything. So, these data are extremely important to help us understand the potential harms and benefits of cannabis use in different contexts.”

Halis K. Akturk, MD, Associate Professor of Medicine and Pediatrics, Barbara Davis Center for Diabetes, University of Colorado, will review several “lows” associated with cannabis use among patients with diabetes, including its effects on glycemic control, diabetic ketoacidosis, and cannabis hyperemesis syndrome.

“After the legalization of cannabis in Colorado, the cannabis-related emergency room (ER) visits and cannabis-related poisonings significantly increased, and cannabis hyperemesis syndrome-related ER visits increased by more than two times,” Dr. Akturk explained.

In addition to several type 1 diabetes management strategies for patients who are cannabis users, Dr. Akturk will spotlight cannabis hyperemesis syndrome.

“Cases of the disease are increasing and it is one of the primary reasons for cannabis-related ER visits for patients with or without diabetes,” Dr. Akturk said, adding that for patients with type 1 diabetes, the syndrome can be challenging to diagnose and is often misdiagnosed as diabetes-related gastroparesis.

Delineating diabetic ketoacidosis from hyperglycemic ketosis due to cannabis hyperemesis syndrome in adults with type 1 diabetes can also be perplexing for health care professionals. Dr. Akturk also will review the diagnostic criteria for hyperglycemic ketosis due to cannabis hyperemesis syndrome he helped develop in 2021.

“What I want to highlight with this presentation is to encourage caution with cannabis use, particularly for patients with type 1 diabetes because it can mimic other disease-related symptoms,” he said.

Jay H. Shubrook, DO, Professor of the Primary Care Department, Touro University California, also will provide insight into the current landscape of cannabis use with key trends clinicians should be aware of.

For those unable to attend the 84^th Scientific Sessions in person, this session will be available on-demand on the virtual meeting platform following the meeting for registered participants.