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Journal of the Endocrine Society logoLink to Journal of the Endocrine Society
. 2025 Oct 22;9(Suppl 1):bvaf149.1710. doi: 10.1210/jendso/bvaf149.1710

MON-236 Exploring Substance Use Among Adolescents With Diabetes: A Retrospective Cross-sectional Analysis Using NSDUH Data

Victoria Zhao 1, Meghana Nair 2, Julianne M Hall 3, Richard Feinn 4
PMCID: PMC12545280

Abstract

Disclosure: V. Zhao: None. M. Nair: None. J.M. Hall: None. R. Feinn: None.

Background: Adolescents living with chronic illnesses, such as diabetes, often face unique stressors that may increase their vulnerability to risky coping behaviors. Limited research exists on the relationship between chronic illness in adolescents and rates of substance misuse. This study aims to evaluate the relationship between diabetes and patterns of substance misuse, including alcohol, marijuana, and prescription pain relievers. By highlighting disparities in substance use behaviors among adolescents with diabetes, this research emphasizes the importance of targeted mental health support and early prevention of substance misuse in medically vulnerable adolescent populations. Methods: The National Survey on Drug Use and Health (NSDUH) 2023 database was used to analyze data regarding substance use among non-institutionalized adolescents in the United States. Adolescents ages 12-20 were included. Self-reported diabetes diagnosis was used as the primary independent variable. Outcome variables included: 1) days of marijuana use in the past year, 2) days of alcohol use in the past year and 3) past-year misuse of prescription pain relievers. A generalized linear model was done to check to see whether the number of days of alcohol consumption and marijuana use within the past year differed by diabetes diagnosis. For prescription pain relievers, a chi-squared test was done to check for associations between the misuse of pain relievers and diabetes diagnosis. Results: A total of 2,563 adolescents aged 12-20 were included in the analysis, of whom 274 reported a diagnosis of diabetes and 2,289 did not. Statistical comparisons were made between the diabetes and non-diabetes groups. Adolescents with diabetes were found to have a significantly higher number of days of alcohol use in the past year (12.92 days, 95% CI: 11.44-14.59) compared to their non-diabetic peers (8.83 days, 95% CI: 8.46-9.22), with a mean difference of 4.09 days (p < 0.001). No statistically significant difference was found in marijuana use between groups, with diabetic adolescents reporting 3.86 days (95% CI: 3.34-4.47) versus 3.56 days (95% CI: 3.38-3.74) in non-diabetic adolescents (p = 0.308). There was also no significant association between diabetes status and past-year misuse of prescription pain relievers (X^2 = 9.324, df = 5, p = 0.097). Conclusion: Adolescents with diabetes demonstrated significantly higher alcohol consumption compared to their nondiabetic peers, with no significant findings in marijuana or prescription pain reliever use. These findings suggest that alcohol may be used as a coping strategy for some adolescents with a diabetes diagnosis. By providing more targeted risk prevention programs for medically vulnerable populations, such as those with a diabetes diagnosis, can empower them to make informed, safe choices regarding substance use.

Presentation: Monday, July 14, 2025


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