Although cannabis is legal in many states and some patients consider it “natural” because of its plant origin and potential for relieving diabetic nerve pain, it can also negatively impact individuals with diabetes, such as increasing the risk of cardiovascular disease.

The risks are concerning because marijuana use among adults with diabetes rose by 33.7% between 2021 and 2022, according to a Diabetes Care study (https://diabetesjournals.org/care/article/47/9/e67/156943/Past-Month-Cannabis-Use-Among-Adults-With-Diabetes).

Adverse Effects of Cannabis

There are many adverse effects of cannabis on diabetes management:

• Cannabis can impair focus and judgement, leading to difficulties in controlling blood sugar. For example, cannabis can impair the brain’s executive function and short-term memory, increasing the risk of forgetting to take insulin, checking glucose levels, or taking medication
• Use of cannabis drives behaviors such as increased appetite, which can cause blood sugar spikes
• Using cannabis might lead to anxiety and an elevated risk of substance abuse
• Cannabis can make the heart beat faster and raise blood pressure immediately after use. It could also lead to an increased risk of stroke, heart disease, and other vascular diseases, according to the CDC.
• The psychoactive effects of cannabis can hide symptoms of low or high blood sugar, making management more difficult

Cannabis can increase the Risk of DKA

A study found moderate cannabis use in 932 type 1 diabetics was associated with a twofold increase in risk for diabetic ketoacidosis (DKA). The article advised that providers should inform their patients of the potential risk of DKA with cannabis use (https://pubmed.ncbi.nlm.nih.gov/31628116/).

Diabetic ketoacidosis (DKA) is a dangerous condition where the body doesn’t have enough insulin to let cells use sugar for energy. As a result, the body breaks down fat for fuel, which can cause a buildup of acids, called ketones, in the blood. Cannabis use can lead to DKA in type 1 diabetes because of impaired self-management behaviors, delayed gastric emptying, and overeating.

American Diabetes Association Standards of Care

The 2025 ADA Standards of Care in Diabetes advises people with diabetes to avoid recreational cannabis in any form. While cannabis is sometimes used for nerve pain, anxiety, or nausea, the ADA doesn’t approve cannabis for diabetes issues. The organization also advises people with diabetes to discuss their use with a healthcare provider.

It’s important to monitor your blood sugar levels carefully before, during, and after use.

While Diabetes Canada also does not recommend recreational cannabis for people with diabetes, it has suggestions for healthcare professionals in dealing with patients who use marijuana. The organization believes healthcare professionals should discuss substance use regularly, with a non-judgmental approach. 

They also advise that adult diabetics considering recreational cannabis use should receive personalized counseling, focusing on risks and reducing adverse effects on diabetes management and complications.

Conclusion

Using marijuana can lead to several negative consequences for individuals with diabetes, including heart disease risks, poor decision-making, and difficulty controlling insulin and blood sugar.

Be honest with your healthcare providers regarding marijuana use. Together, you and your healthcare providers can decide if you need to change your diet, exercise, or medications.

Quote

“In some cases, patients may also use cannabis to cope with diabetes-related burnout; while this may offer temporary relief, it can promote disengagement from routine self-care and worsen overall disease management.” Dr. Ajani Jackson, Marietta Springs Behavioral Healthcare

Disclaimer

Please remember this is not medical advice or intended to replace the advice of your doctor. Please do not self-diagnose and always check with your healthcare provider before trying new treatments.

Also, natural does not mean safe. Many natural remedies have side effects and can interact with medication and supplements. It should be noted that the FDA does not regulate dietary supplements but treats them as foods rather than medications. Unlike drug manufacturers, supplement makers do not have to show their products are safe or effective.

I ask you to please keep an open mind, be a diabetic detective, do your own research, work with your healthcare team, see what works best for you, and monitor your blood sugars.