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Review
. 2020 Aug 17;9(1):187.
doi: 10.1186/s13643-020-01411-9.

The effects of recreational cannabis use on glycemic outcomes and self-management behaviours in people with type 1 and type 2 diabetes: a rapid review

Caroline J Porr  1 , Patricia Rios  2 , Harpreet S Bajaj  3   4 , Aoife M Egan  5   6 , Celine Huot  7 , Ryan Batten  1 , Lisa Bishop  1 , Devonne Ryan  1 , Erin Davis  1 , Nazia Darvesh  2 , Arifur Rahman  1 , Shabnam Asghari  1 , Lily Acheampong  1 , Andrea C Tricco  8   9   10   11
Affiliations
Review

The effects of recreational cannabis use on glycemic outcomes and self-management behaviours in people with type 1 and type 2 diabetes: a rapid review

Caroline J Porr et al. Syst Rev. .

Abstract

Background: Recent surveys of Canadian cannabis users reflect increasing consumption rates, some of whom may have diabetes. However, healthcare providers have limited information resources on the effects of recreational cannabis in people with diabetes. This rapid review was commissioned by Diabetes Canada to synthesize available evidence to guide recommendations for care of people 13 years of age and older who live with diabetes.

Methods: PubMed, Embase and PsycINFO databases were searched from January 2008 to January 2019. Study selection, data abstraction and quality appraisal were completed by pairs of reviewers working independently and discrepancies were resolved by a third reviewer with pilot tests completed before each stage to ensure consistency. Data collected from included studies were tabulated and summarized descriptively.

Results: The search resulted in 1848 citations of which 59 publications were selected for screening, resulting in six observational studies (2 full-text articles and 4 conference abstracts) that met the pre-defined criteria for inclusion. Five studies reported higher glycated hemoglobin (HbA1c) in people with type 1 diabetes (T1D) who consumed recreational cannabis. In one study, students aged 17 to 25 years living with T1D self-reported poorer glycemic control and higher HbA1c when smoking cannabis. In one study of adults with T1D, cannabis use within the previous 12 months was associated with almost double the risk of diabetic ketoacidosis compared with no cannabis use (odds ratio [OR] 1.98; confidence interval [CI] [95% CI] 1.01-3.91). Risks for peripheral arterial occlusion and myocardial infarction were found to be higher in people with type 2 diabetes (T2D) who consumed recreational cannabis, and worse renal parameters were also reported in two separate studies of T1D and T2D.

Conclusions: Recreational cannabis use may negatively impact diabetes metabolic factors and self-management behaviours in people with T1D. In people with T2D, recreational cannabis may increase risks for peripheral arterial occlusion, myocardial infarction and renal disease. However, the evidence base of this rapid review was limited to six observational studies of poor to fair methodological quality, and thus, further robust, higher quality research is required to confirm the potential impact of cannabis on diabetes.

Systematic review registration: PROSPERO CRD42019122829.

Keywords: Cannabis; Diabetes metabolic factors; Diabetes self-management; Knowledge synthesis; Type 1 diabetes; Type 2 diabetes.

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Conflict of interest statement

Dr. Andrea Tricco is a member of the editorial board at BMC Systematic Reviews, but was not involved with the peer review process/decision to publish this manuscript. Harpreet Bajaj is involved in honoraria and/or research support, outside the submitted work from Abbott, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi and Valeant. Celine Huot is involved as a local principal investigator in clinical trials for the treatment of diabetes in the pediatric population: Novo Nordisk and Sanofi Aventis. All other authors have no known conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Study flow diagram
See this image and copyright information in PMC

References

    1. Rotermann M, Macdonald R. Analysis of trends in the prevalence of cannabis use in Canada, 1985 to 2015. 2018. - PubMed
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    1. Government of Canada . Canadian Cannabis Survey 2018 Summary. 2018.
    1. Canadian Centre on Substance Abuse and Addiction . Cannabis (Canadian Drug Summary) 2018.
    1. Government of Canada . Health fact sheets diabetes. 2019.

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