Diabetes Canada Position Statement on Recreational Cannabis Use in Adults and Adolescents With Type 1 and Type 2 Diabetes

Objective: Pursuant to the legalization of recreational cannabis in Canada, a rapid review was undertaken to develop a position statement concerning the effects of cannabis consumption on Canadians living with diabetes. Methods: An expert committee of 1 adult endocrinologist and 1 pediatric endocrinologist, with the help of coauthors, collaborated to develop the position statement using the same evidence-based principles as the Diabetes Canada Clinical Practice Guidelines (with the exception of an independent methods review). A rapid review was conducted by researchers with the Strategic Patient-Oriented Research Evidence Alliance. The scope of the review was limited to evaluating the effects of recreational cannabis use on: 1) metabolic factors and diabetes complications, and 2) diabetes self-management behaviors in people >= 13 years of age. An informed person with diabetes, Canadian health-care providers and scientific advisors performed independent external reviews. Results: The review found a limited amount of published or presented literature for the review questions, with gaps in direct evidence linking cessation of cannabis use to improved outcomes in diabetes. However, there were sufficient data to begin developing recommendations for type 1 and type 2 diabetes about education, counseling and management related to recreational cannabis usage. Conclusions: This is the first attempt in the world to generate an evidence-based guidance document on the topic of recreational cannabis use and diabetes. It provides guidance for health-care providers, so that they can assist and counsel Canadians living with diabetes on recreational cannabis. Further, higher quality research is required to provide more robust and evidence-informed guidance. (C) 2019 Canadian Diabetes Association.