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

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.

Association of prenatal exposure to opioids, cannabis, and polysubstance use with cord blood DNA methylation patterns in a multiancestry cohort

“…50 Therefore, DNA methylation changes in C2CD4B may be related to metabolic and vascular processes potentially impacted by cannabis exposure, though it is not clear what link there may be between cannabis and glucose metabolism. 51,52 Further studies to investigate the relationship between cannabis exposure, C2CD4B methylation, and cardiometabolic conditions are needed. This is the rst epigenome-wide association screen for prenatal polysubstance exposure.…”

The association between preconception cannabis use and gestational diabetes mellitus: The Preconception Period Analysis of Risks and Exposures Influencing health and Development (PrePARED) consortium

“…1 Some studies show that cannabis use correlates with increased HbA1c among people with type 1 diabetes. 11 Preconception cannabis use might increase the risk of GDM by increasing caloric intake, body weight and the risk of maternal gestational fatty liver that is associated with insulin resistance. 1 Tetrahydrocannabinol (THC) can be rapidly absorbed and stored in adipose tissue, detectable in fat biopsies up to 4 weeks and in urine up to 11 weeks after use, 12 potentially impacting pregnancy outcomes even if stopped early in pregnancy.…”

“…Cannabis can affect adiposity distribution, serum leptin, appetite and the gastrointestinal system 1 . Some studies show that cannabis use correlates with increased HbA1c among people with type 1 diabetes 11 . Preconception cannabis use might increase the risk of GDM by increasing caloric intake, body weight and the risk of maternal gestational fatty liver that is associated with insulin resistance 1 .…”

The Association of Cannabis Use Disorder and Perioperative Complications After Primary Total Knee Arthroplasty

“…These comorbid conditions were chosen as previous investigations have found a higher prevalence of these conditions within patients with CUD. [21][22][23][24][25]…”