Cannabis use is increasing worldwide, with almost 220 million users in 2021. Studies have found that cannabis may have anti-inflammatory properties and may be useful for treating eating disorders.

The appetite stimulation — think munchies — that makes cannabis potentially helpful for people with anorexia could have a downside when it comes to blood sugar. Studies have raised concerns that cannabis use might be associated with heart problems and the disruption of glucose metabolism.

The metabolic effects of long-term cannabis and the likelihood of long-term users developing type 2 diabetes has been unclear, but a recent study suggests a connection.

It's not yet clear whether type 2 diabetes is associated only with smoking or vaping cannabis, or if it also increases with edibles.

A team of researchers at the Boston Medical Center analyzed electronic health records for almost 97,000 cannabis users and found they were almost four times more likely to develop type 2 diabetes compared to more than four million healthy controls who did not use cannabis. New cases of diabetes were diagnosed in more than 1,900 participants or 2.2 percent of the cannabis group, but only in 0.6 percent of the control group.

Study participants were between 18 and 50 years old. About 50 percent were female. Participants' cannabis use ranged from occasional to a diagnosis of dependence. Both the cannabis and control groups were followed for five years.

“As cannabis becomes more widely accepted and legal in various jurisdictions, it is essential to understand its potential health risks,” Ibrahim Kamel, lead author on the study, said in a statement.

The findings could influence metabolic monitoring practices, including measuring blood glucose and cholesterol levels, and public health messaging.

Kamel, a clinical instructor at Boston Medical Center, said these findings support incorporating diabetes risk awareness into addiction services and counseling. “Healthcare professionals can routinely talk to their patients about cannabis use, so patients can understand their diabetes risk and need for metabolic monitoring,” he said.

Cannabis users were almost four times more likely to develop type 2 diabetes.

More studies are needed to explain the connection between cannabis use and type 2 diabetes risk. The researchers think it may be related to unhealthy eating habits and the development of insulin resistance, but this study only shows an association between cannabis use and type 2 diabetes risk. It does not prove cannabis use causes it, said the researchers.

Additional research is needed to determine if an elevated type 2 diabetes risk is associated only with smoking or vaping cannabis or other forms of use such as edibles also increase it.

The study findings were presented at the annual meeting of The European Association for the Study of Diabetes. It has not yet been published in a peer-reviewed journal.