Overview

• Researchers at Boston Medical Center analyzed TriNetX records from 54 health systems, comparing 96,795 adults with cannabis‑related diagnoses to 4,160,998 matched non‑users aged 18 to 50 over five years.
• Incident type 2 diabetes occurred in 2.2% of cannabis‑coded patients (1,937 cases) versus 0.6% of controls (518 cases), indicating nearly a fourfold higher risk.
• The authors stress the study is retrospective and cannot establish causation, citing potential exposure misclassification, unmeasured confounding, and a lack of data on product type, dose, route, or frequency.
• Proposed explanations include insulin resistance linked to endocannabinoid CB1 activation, increased visceral and hepatic fat, and eating patterns such as higher caloric intake after use.
• Clinicians are encouraged to discuss cannabis use during visits and consider metabolic monitoring, while researchers call for prospective and mechanistic studies to test causality and assess risks by product and use patterns.