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836-P: Cannabis Use in Adults with Type 1 Diabetes (T1D) Is Associated with Poor Glycemic Control and Increased Risk for Diabetic Ketoacidosis (DKA)

Cannabis has been legalized for medical or recreational use in 33 states and usage is increasing in adults. A prior study from Colorado showed a two-fold increased DKA risk among adults with T1D using cannabis. This study was aimed to evaluate glycemic control and DKA risk among adults with T1D who use cannabis from the T1D Exchange Clinic Registry (T1DX). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) questionnaire was emailed to 4311 adults at 69 T1DX clinic registry centers. Total Substance Score (TSC) for cannabis was used to classify adults with T1D requiring no intervention (TSC score 0-3), a brief intervention (TSC 4-26), and more intensive intervention (>26). A total of 932 adults with T1D completed the survey (61% female, 90% non-Hispanic white, mean age 38±16 years). The prevalence of cannabis use was 17.8%; prevalence was higher in states where cannabis is legal. Compared to participants categorized as ‘no intervention’ (n=871), cannabis users ‘brief intervention’ (n=61) were younger, had a younger age at T1D diagnosis, had higher A1c, and had similar use of insulin pumps and CGMs. Cannabis use (TSC >4) was associated with increased DKA risk (OR 2.5, 1.0-5.9) after adjusting for age, sex and A1c [Figure]. With the growing use of cannabis among adults with T1D, physicians should be aware of an association between cannabis use and a risk for DKA. Disclosure V.N. Shah: Advisory Panel; Self; Sanofi US. Consultant; Self; Dexcom, Inc. D.D. Taylor: None. N.C. Foster: None. R. Beck: Other Relationship; Self; Abbott Laboratories, Ascensia Diabetes Care, Bigfoot Biomedical, Dexcom, Inc., Insulet Corporation, Lilly Diabetes, Roche Diabetes Care, Tandem Diabetes Care. H.K. Akturk: Advisory Panel; Self; Sanofi. Research Support; Self; Eli Lilly and Company, MannKind Corporation, REMD Biotherapeutics. Speaker9s Bureau; Self; MannKind Corporation. G.L. Kinney: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust