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The Effects of Substance Abuse on Blood Glucose Parameters in Patients with Diabetes: A Systematic Review and Meta-Analysis.

Abstract

Background:

People who abuse substances are at increased risk of metabolic syndrome and diabetes resulting partly from increased cell damage and due to the effects of opioids on glucose homeostasis. Therefore, people with diabetes who abuse substances may carry greater health risks than the general population resulting from their effect on glucose metabolism. These substances may be in the form of cannabis, hallucinogens, opioids, and stimulants. Therefore, the aim of this review was to evaluate the effects of substance abuse on blood glucose parameters in patients with diabetes. Method: Databases including Embase, Psycho-Info, Google Scholar and PubMed were searched systematically for relevant articles from database inception to May 2018. Search terms including medical subject headings (MeSH) based on the Population, Intervention, Comparator and Outcomes (PICO) framework was used to access the databases. Eligible articles were selected based on set inclusion and exclusion criteria. The articles reviewed were evaluated for quality and meta-analysis and sensitivity analysis were carried out using the Review Manager (RevMan 5.3, The Cochrane Collaboration, Copenhagen, Denmark). The Random effects model was used for the data analysis.

Results:

Twelve studies which met the inclusion criteria were included in the systematic review, while nine articles were selected for the meta-analysis. The results of the meta-analysis showed that substance abuse does not have significant effects (p > 0.05) on postprandial blood glucose and glycated haemoglobin in patients with diabetes. With respect to the effect of substance abuse on fasting blood glucose, while this was significant (p < 0.05) following meta-analysis, the results of the sensitivity test did not demonstrate any significant difference (p > 0.05) between patients who abused substances compared with control. This would suggest that the effect of substance abuse on fasting blood glucose in these patients was not very reliable or not consistent.

Conclusions:

The effect of substance abuse on glycated haemoglobin and postprandial blood glucose in patients with diabetes was not significant. In the meta-analysis, while the value was slightly lower with respect to postprandial blood glucose, this was slightly higher in relation to HbA1c in the substance abuse group compared with control. On the other hand, the effect of substance abuse on fasting blood glucose was significant (p = 0.03) compared with control, but this was attenuated following a sensitivity test. A range of factors including eating habits, characteristics of drugs, erratic lifestyle of patients may explain the outcome of this review. There is the need for randomised controlled trials that will include diet and medication history in order to fully understand the effect of substance abuse on blood glucose parameters in patients with diabetes.

Authors+Show Affiliations

Department of Adult Nursing and Paramedic Science, University of Greenwich, London SE9 2UG, UK. o.ojo@greenwich.ac.uk.The School of Nursing, Soochow University, Suzhou 215006, China. wangxiaohua@suda.edu.cn.University Hospital, Lewisham High Street, London SE13 6LH, UK. eseojo1@gmail.com.Department of Family Care & Mental Health, University of Greenwich, London SE9 2UG, UK. J.C.Ibe@greenwich.ac.uk.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

30501025

Citation

Ojo, Omorogieva, et al. "The Effects of Substance Abuse On Blood Glucose Parameters in Patients With Diabetes: a Systematic Review and Meta-Analysis." International Journal of Environmental Research and Public Health, vol. 15, no. 12, 2018.
Ojo O, Wang XH, Ojo OO, et al. The Effects of Substance Abuse on Blood Glucose Parameters in Patients with Diabetes: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2018;15(12).
Ojo, O., Wang, X. H., Ojo, O. O., & Ibe, J. (2018). The Effects of Substance Abuse on Blood Glucose Parameters in Patients with Diabetes: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health, 15(12), doi:10.3390/ijerph15122691.
Ojo O, et al. The Effects of Substance Abuse On Blood Glucose Parameters in Patients With Diabetes: a Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2018 11 29;15(12) PubMed PMID: 30501025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Effects of Substance Abuse on Blood Glucose Parameters in Patients with Diabetes: A Systematic Review and Meta-Analysis. AU - Ojo,Omorogieva, AU - Wang,Xiao-Hua, AU - Ojo,Osarhumwese Osaretin, AU - Ibe,Jude, Y1 - 2018/11/29/ PY - 2018/10/27/received PY - 2018/11/23/revised PY - 2018/11/27/accepted PY - 2018/12/2/entrez PY - 2018/12/7/pubmed PY - 2019/4/19/medline KW - blood glucose parameters KW - diabetes KW - fasting blood glucose KW - glycated haemoglobin KW - meta-analysis KW - opioids KW - postprandial blood glucose KW - substance abuse KW - systematic review JF - International journal of environmental research and public health JO - Int J Environ Res Public Health VL - 15 IS - 12 N2 - Background: People who abuse substances are at increased risk of metabolic syndrome and diabetes resulting partly from increased cell damage and due to the effects of opioids on glucose homeostasis. Therefore, people with diabetes who abuse substances may carry greater health risks than the general population resulting from their effect on glucose metabolism. These substances may be in the form of cannabis, hallucinogens, opioids, and stimulants. Therefore, the aim of this review was to evaluate the effects of substance abuse on blood glucose parameters in patients with diabetes. Method: Databases including Embase, Psycho-Info, Google Scholar and PubMed were searched systematically for relevant articles from database inception to May 2018. Search terms including medical subject headings (MeSH) based on the Population, Intervention, Comparator and Outcomes (PICO) framework was used to access the databases. Eligible articles were selected based on set inclusion and exclusion criteria. The articles reviewed were evaluated for quality and meta-analysis and sensitivity analysis were carried out using the Review Manager (RevMan 5.3, The Cochrane Collaboration, Copenhagen, Denmark). The Random effects model was used for the data analysis. Results: Twelve studies which met the inclusion criteria were included in the systematic review, while nine articles were selected for the meta-analysis. The results of the meta-analysis showed that substance abuse does not have significant effects (p > 0.05) on postprandial blood glucose and glycated haemoglobin in patients with diabetes. With respect to the effect of substance abuse on fasting blood glucose, while this was significant (p < 0.05) following meta-analysis, the results of the sensitivity test did not demonstrate any significant difference (p > 0.05) between patients who abused substances compared with control. This would suggest that the effect of substance abuse on fasting blood glucose in these patients was not very reliable or not consistent. Conclusions: The effect of substance abuse on glycated haemoglobin and postprandial blood glucose in patients with diabetes was not significant. In the meta-analysis, while the value was slightly lower with respect to postprandial blood glucose, this was slightly higher in relation to HbA1c in the substance abuse group compared with control. On the other hand, the effect of substance abuse on fasting blood glucose was significant (p = 0.03) compared with control, but this was attenuated following a sensitivity test. A range of factors including eating habits, characteristics of drugs, erratic lifestyle of patients may explain the outcome of this review. There is the need for randomised controlled trials that will include diet and medication history in order to fully understand the effect of substance abuse on blood glucose parameters in patients with diabetes. SN - 1660-4601 UR - https://www.unboundmedicine.com/medline/citation/30501025/The_Effects_of_Substance_Abuse_on_Blood_Glucose_Parameters_in_Patients_with_Diabetes:_A_Systematic_Review_and_Meta_Analysis_ L2 - http://www.mdpi.com/resolver?pii=ijerph15122691 DB - PRIME DP - Unbound Medicine ER -