Writing in the journal Diabetic Medicine (26:328-33) , diabetes specialists from St Vincent’s Hospital in Sydney say GPs should accept that many if not most of their young diabetic patients will try recreational drugs and clinicians should have ‘a high index of suspicion’ for drug use as a possible cause of poor diabetes control or acute complications.
They say recent studies have shown that more than half of young people with diabetes who present with problems to hospitals have used drugs, the most common being cannabis and ecstasy.
They note that ecstasy can cause hyponatraemia and ketoacidosis, while drugs such as ketamine can precipitate severe diabetic ketoacidosis.
Cannabis use may cause insulin non-compliance and lead to hyperglycaemia if users get ‘the munchies’.
The risks of recreational drugs are amplified in settings such as raves and parties where poly-drug use is common, drink spiking may occur and consumption of high glucose drinks is encouraged. Therefore, doctors should routinely ask about drug use in diabetic patients, and take a non-judgmental approach because most young patients will be reluctant to admit to drug use, they suggest.
“We advocate increased awareness of the impact of drug use on Type 1 diabetes, as the consequences may be fatal…substance use should be considered even without suggestive history, particularly with atypical biochemical features,” they say.
Experts suggest contacting an drug addiction treatment center or drug rehab program for more information regarding poly-drug use and the dangers of club drugs or other kind of drug rehabilitation.