Substance Use in Adults With Type 1 Diabetes in the T1D Exchange

The purpose of the study was to evaluate frequency of use and problem use of psychoactive substances in adults with type 1 diabetes (T1D).

Standardized instruments for assessing tobacco, alcohol, and other psychoactive substance use were emailed to 4311 adult participants at 69 T1D Exchange Registry Exchange Registry centers. A total of 936 respondents (61% female, 90% non-Hispanic white, age 38 ± 16 years) completed the survey.

In the sample, 166 (18%) reported past-year use of tobacco and 51 (5%) reported daily use. Past-year alcohol use was reported by 742 (79%) participants, past-month use by 592 (63%), and daily/near-daily use by 87 (9%); 174 (19%) were classified as binge drinkers and 93 (11%) as problem drinkers. Nonprescription use of another psychoactive substance in the past year was reported by 228 (24%), with 167 (18%) indicating they used marijuana, 67 (7%) opioids, 45 (5%) sedatives, and 37 (4%) stimulants. Past-year problem use of these substances was noted in 31 (3%) respondents.

Adults with T1D in the United States use substances at rates that meet or exceed the general population; problematic use occurs at rates similar to the general population. These data delineate the need to inquire about regular, intermittent, and problematic use of nicotine and other substances in individuals with T1D. A better understanding of the impact of moderate and occasional use of substances on T1D management and clinical outcomes is needed.