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
Mots clés
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Article Info
Publication History
Published online: May 14, 2019
Accepted:
May 6,
2019
Received in revised form:
April 4,
2019
Received:
February 27,
2019
Identification
Copyright
© 2019 Canadian Diabetes Association.
