Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON, M5B 1W8, Canada.
Syst Rev. 2020 Aug 17;9(1):187. doi: 10.1186/s13643-020-01411-9.
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.
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.
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.
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.
PROSPERO CRD42019122829.
最近对加拿大大麻使用者的调查反映出消费率不断上升，其中一些人可能患有糖尿病。然而，医疗保健提供者在娱乐性大麻对糖尿病患者的影响方面的信息资源有限。这项快速审查是由加拿大糖尿病协会委托进行的，旨在综合现有证据，为 13 岁及以上患有糖尿病的人的护理提供建议。
从 2008 年 1 月至 2019 年 1 月，在 PubMed、Embase 和 PsycINFO 数据库中进行了检索。研究选择、数据提取和质量评估由两组独立工作的评审员完成，如果出现分歧，则由第三名评审员解决，并在每个阶段之前进行试点测试以确保一致性。从纳入的研究中收集的数据被制成表格并进行描述性总结。
检索结果产生了 1848 条引文，其中有 59 篇出版物被筛选，最终有六项观察性研究（两篇全文文章和四篇会议摘要）符合纳入的预定义标准。五项研究报告称，1 型糖尿病（T1D）患者中，吸食娱乐性大麻会导致糖化血红蛋白（HbA1c）升高。在一项针对 17 至 25 岁患有 T1D 的学生的研究中，自我报告的吸烟大麻会导致血糖控制更差和 HbA1c 升高。在一项针对 1 型糖尿病成年人的研究中，与没有使用大麻相比，在过去 12 个月内使用大麻与糖尿病酮症酸中毒的风险几乎增加了一倍（比值比 [OR] 1.98；置信区间 [CI] [95% CI] 1.01-3.91）。还发现，2 型糖尿病（T2D）患者吸食娱乐性大麻会增加外周动脉闭塞和心肌梗死的风险，而两项针对 T1D 和 T2D 的单独研究报告称，肾脏参数也更差。
娱乐性大麻的使用可能会对 1 型糖尿病患者的糖尿病代谢因素和自我管理行为产生负面影响。在 2 型糖尿病患者中，娱乐性大麻可能会增加外周动脉闭塞、心肌梗死和肾脏疾病的风险。然而，本快速审查的证据基础仅限于六项质量较差或一般的观察性研究，因此，需要进行更可靠、更高质量的研究来证实大麻对糖尿病的潜在影响。
PROSPERO CRD42019122829。
