Why Diabetics Should Quit Smoking: One Woman’s Medical Saga

By Cassidy Morrison Senior Health Reporter for Dailymail.Com

Updated: 13:15 04 March 2023

Doctors are warning of the risk of cannabis for diabetics after a woman was stricken with a debilitating illness for two years.

The 23-year-old, who suffered from type 1 diabetes, had been in and out of hospital with vomiting and severe nausea that puzzled doctors who struggled to determine the cause.

She was misdiagnosed with a diabetes-related stomach problem that prevents food from being eliminated from the body.

But doctors were missing a key detail – that the young woman had been an avid marijuana user for eight years. She didn’t reveal it until a later visit, where she was diagnosed with cannabinoid hyperemesis syndrome (CHS).

At first, doctors in Athens, Georgia, believed the woman, who had uncontrolled type 1 diabetes and stage 3 kidney failure, was suffering from a condition marked by the stomach’s inability to empty. It wasn’t until she shared with doctors that she was a habitual marijuana user that they began to link it to cannabinoid hyperemesis syndrome (file image)

CHS is caused by frequent, long-term cannabis use that results in repeated episodes of vomiting, severe nausea, stomach pain, and dehydration.

Marijuana can be particularly dangerous for people with diabetes who use it regularly over a long period of time.

Cannabis users with type 1 diabetes are twice as likely as non-users to develop diabetic ketoacidosis, a life-threatening condition characterized by a buildup of acids in the blood due to prolonged periods of high blood sugar.

A team of gastroenterologists from the Piedmont Regional Medical Center in Athens, Georgia revealed the case in a report published in the American Journal of Case Reports.

The doctors wrote in the case study: “With the legalization of cannabis in the United States, clinicians can expect to encounter more and more patients with complications related to cannabis use.

“This report has shown the importance of taking a complete social history in all patients, including patients with type 1 diabetes, and is a reminder that cannabinoid use can cause severe nausea, vomiting and pain. abdominal pain in this group of patients.”

The patient – who has not been named – had seven years of type 1 diabetes which doctors described as ‘uncontrolled’, meaning here her blood sugar was too high despite her condition being treated. This put him at risk of life-threatening diabetic ketoacidosis.

The team of doctors initially believed it to be a case of diabetic gastroparesis (dgp), a condition in which your stomach struggles to evacuate its contents due to damaged abdominal muscles, allowing food to stay in your body longer than they should. Although a visit six months before admission that the doctors discussed in the case study revealed that she had “normal gastric emptying”.

But doctors didn’t learn of his history of regular marijuana use until later.

When she told the doctors, they considered the possibility that they were in fact dealing with a little-understood case of CHS, which would affect an estimated 2.75 million Americans, although the true burden is difficult to assess. because CHS is a newly discovered disease. and people may not want to disclose how much marijuana they use.

Some heavy marijuana users can get CHS while others cannot. Experts still don’t know how cannabis causes CHS symptoms, but some believe genetics plays a role.

CHS takes a long time to develop, so the occasional smoker is very unlikely to develop symptoms. But for a daily user, it’s a different story.

Many people with symptoms of CHS complain of “scromiting” or episodes of vomiting and intense simultaneous crying. Symptoms also include stomach pain and cramps, as well as severe dehydration which depletes the body’s electrolytes, increasing the risk of kidney disease.

Although there is no specific dose of THC that will definitely cause the development of CHS, some patients with the disease have admitted to smoking 2000 mg of THC per day, which is 50 times the maximum recommended dose.

Marijuana users hit by waves of vomiting and nausea in legal states

Emergency rooms in states where marijuana is legal have seen an influx of habitual users admitted for uncontrollable vomiting and intestinal disorders.

When he was last admitted to hospital, doctors observed a diagnosis of CHS. She received IV hydration, an anti-nausea drug, and an intravenous infusion of the antipsychotic drug Haldol typically used to treat schizophrenia, Tourette’s syndrome tics, bipolar disorder mania, delirium, agitation, acute psychosis and hallucinations due to alcohol withdrawal.

The patient continued to have severe upper abdominal pain although the CT scan and other imaging tests were normal.

The doctors wrote: ‘At this point, given her history of chronic cannabis use and non-revealing previous investigations, the CHS was more concerned. Analyzing her history further, she reported a marked improvement in symptoms after the hot baths.

Most people with CHS-induced bowel problems will find relief in a warm shower or bath. The pain can be so acute for some that hot showers turn into hour-long activities.

“On further analysis of her history, she reported a marked improvement in symptoms after the hot baths.” She smoked cannabis at least 5 times a week and her last use was 2 days before the presentation.

“After discharge, she abstained from cannabis for 2 months during which time she remained symptom-free until she started using cannabis again and the symptoms reappeared.”

The case study is just one example of doctors struggling to diagnose the relatively new disease.

The first case of CHS was described in 2004 by Australian doctors who followed a series of patients who developed nausea, vomiting and abdominal pain after regularly using marijuana. Their symptoms stopped when they stopped using the drug, and symptoms returned when they did.

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