This CDS tool aids in the detection of Cannabis Hyperemesis Syndrome (CHS) in individuals with Type 1 Diabetes Mellitus (T1DM) experiencing diabetic ketoacidosis (DKA) with ketosis but lacking significant metabolic acidosis. It evaluates clinical and laboratory parameters to support differential diagnosis and guide management decisions.
Hyperglycemic ketosis in individuals with type 1 diabetes using cannabis is associated with cannabis hyperemesis syndrome, which is marked by severe nausea, abdominal pain, and vomiting. Recommended diagnostic criteria for hyperglycemic ketosis cannabis hyperemesis syndrome include a blood glucose of ≥250 mg/dL, an anion gap of >10, a serum β-hydroxybutyrate level of >0.6 mmol/L, a pH level of ≥7.4, and a bicarbonate level of ≥15 mmol/L.
Advise people with type 1 diabetes (C) and those with other forms of diabetes at risk for diabetic ketoacido sis not to use recreational cannabis in any form. (E)
American Diabetes Association Professional Practice Committee for Diabetes, 2026, 'Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2026', Diabetes Care, vol. 49, supp. 1, pp. S89–S131.