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Effects of Cannabis Use in Youth and Young Adults With Type 1 Diabetes: The Highs, the Lows, the Don't Knows

  • Jill Pancer
    Affiliations
    Division of Endocrinology and Metabolism, Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada

    Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
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  • Kaberi Dasgupta
    Correspondence
    Address for correspondence: Kaberi Dasgupta MD, MSc, Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 Boulevard de Maisonneuve Ouest, Office 3E.09, Montréal, Québec H4A 3S5, Canada.
    Affiliations
    Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montréal, Québec, Canada

    Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada
    Search for articles by this author

      Abstract

      Our objective was to address the request by our Diabetes Canada/Canadian Institutes of Health Research–funded Virtual Patient Network (VPN) of youth and young adults with type 1 diabetes for information on the impact of cannabis use on type 1 diabetes. To respond to this patient-initiated request, we conducted a literature search in PubMed, with search terms relevant to the following: cannabis use in youth with type 1 diabetes, effects of cannabis use on glycemic control and diabetic emergencies and immune-modulating properties of cannabis. These were synthesized in a narrative review. The number of studies is limited and is based largely on self-report and cross-sectional assessment. The existing literature indicates that 10% to 30% of youth and young adults with type 1 diabetes report ever using cannabis, similarly to the general population. Use appears to be associated with higher glycated hemoglobin and greater diabetic ketoacidosis incidence. There is some evidence of poorer self-management during episodes of use. Cannabis has been shown to be protective against type 1 diabetes in animal models, but such findings have yet to be replicated in humans. Existing cross-sectional studies suggest adverse effects of cannabis use on glycemic control and self-management. However, it is not clear if the associations identified are due to use itself or other patient or contextual factors. Nonetheless, given high use rates, health-care providers should query use, discuss its potential impact on diabetes management and outcomes, and codevelop an action plan.

      Résumé

      Notre objectif était de traiter la demande du réseau VPN (Virtual Patient Network) financé par les IRSC et Diabète Canada pour les jeunes et les jeunes adultes atteints du diabète de type 1 concernant des renseignements sur les conséquences de l'utilisation du cannabis sur le diabète de type 1. Pour répondre à la demande des patients, nous avons mené une recherche bibliographique dans PubMed à l'aide de termes de recherche en rapport avec ce qui suit: l'utilisation du cannabis chez les jeunes atteints du diabète de type 1, les effets de l'utilisation du cannabis sur la régulation de la glycémie et les urgences liées au diabète, et les propriétés immunomodulatrices du cannabis. Tous ces thèmes ont fait l'objet d'une synthèse dans une revue narrative. Le nombre d'études est limité et repose en grande partie sur l'auto-déclaration et l'évaluation transversale. La littérature existante indique que de 10 % à 30 % des jeunes et des jeunes adultes atteints du diabète de type 1 déclarent, tout comme la population générale, avoir déjà utilisé du cannabis. L'utilisation semble associée à une hémoglobine glyquée plus élevée et à un nombre plus grand de cas d'acidocétose diabétique. Des données montrent que la prise en charge autonome est plus mauvaise durant les périodes d'utilisation. Les modèles animaux ont permis de démontrer que le cannabis protège contre le diabète de type 1, mais ces résultats n'ont pas encore été reproduits chez les humains. Les études transversales existantes montrent que l'utilisation du cannabis a des effets indésirables sur la régulation de la glycémie et la prise en charge autonome. Toutefois, il est difficile de savoir si les associations établies sont dues à l'utilisation en soi ou à d'autres facteurs en lien avec le patient ou le contexte. Néanmoins, compte tenu des taux élevés d'utilisation, les prestataires de soins de santé devraient se questionner sur l'utilisation, discuter de ses conséquences potentielles sur la prise en charge et les résultats liés au diabète, et élaborer conjointement un plan d'action.

      Keywords

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