{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T04:15:15Z","timestamp":1775276115167,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T00:00:00Z","timestamp":1543449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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 &gt; 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 &lt; 0.05) following meta-analysis, the results of the sensitivity test did not demonstrate any significant difference (p &gt; 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.<\/jats:p>","DOI":"10.3390\/ijerph15122691","type":"journal-article","created":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T11:47:53Z","timestamp":1543492073000},"page":"2691","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["The Effects of Substance Abuse on Blood Glucose Parameters in Patients with Diabetes: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0071-3652","authenticated-orcid":false,"given":"Omorogieva","family":"Ojo","sequence":"first","affiliation":[{"name":"Department of Adult Nursing and Paramedic Science, University of Greenwich, London SE9 2UG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Hua","family":"Wang","sequence":"additional","affiliation":[{"name":"The School of Nursing, Soochow University, Suzhou 215006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osarhumwese Osaretin","family":"Ojo","sequence":"additional","affiliation":[{"name":"University Hospital, Lewisham High Street, London SE13 6LH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jude","family":"Ibe","sequence":"additional","affiliation":[{"name":"Department of Family Care &amp; Mental Health, University of Greenwich, London SE9 2UG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1080\/10550490601000421","article-title":"Association between opium abuse and comorbidity in diabetic men","volume":"15","author":"Shiri","year":"2006","journal-title":"Am. J. Addict."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s11892-017-0832-0","article-title":"Substance use disorders among patients with Type 2 Diabetes: A dangerous but understudied combination","volume":"17","author":"Walter","year":"2017","journal-title":"Curr. Diabetes Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.3109\/01480545.2011.649286","article-title":"Manifold implications of forgotten hyperglycemia in clinical opiate dependence","volume":"36","author":"Reece","year":"2013","journal-title":"Drug Chem. Toxicol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6","DOI":"10.4103\/2321-0656.176570","article-title":"Opioid use and diabetes: An overview","volume":"4","author":"Sharma","year":"2016","journal-title":"J. Soc. Health Diabetes"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"148","DOI":"10.12968\/pnur.2012.23.3.148","article-title":"Substance use and diabetes: Practical solutions","volume":"23","author":"Hamilton","year":"2012","journal-title":"Pract. Nurs."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e008508","DOI":"10.1136\/bmjopen-2015-008508","article-title":"The spectrum of unhealthy drug use and quality of care for hypertension and diabetes: A longitudinal cohort study","volume":"5","author":"Kim","year":"2015","journal-title":"BMJ Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1080\/13548506.2014.991334","article-title":"Patients with diabetes respond well to contingency management treatment targeting alcohol and substance use","volume":"20","author":"Walter","year":"2015","journal-title":"Psychol. Health Med."},{"key":"ref_8","first-page":"954","article-title":"Drug addiction and diabetes: South Asian action","volume":"67","author":"Kalra","year":"2017","journal-title":"JPMA J. Pak. Med. Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1111\/j.1399-5448.2007.00307.x","article-title":"Tobacco, alcohol, and illicit drug use in adolescents with diabetes mellitus","volume":"8","author":"Araneda","year":"2007","journal-title":"Pediatr. Diabetes"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1002\/pdi.821","article-title":"Diabetes and illicit drug use","volume":"22","author":"Sheldon","year":"2005","journal-title":"Pract. Diabetes Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1080\/13556210410001674095","article-title":"Effects of opium addiction on some serum factors in addicts with non-insulin-dependent diabetes mellitus","volume":"9","author":"Karam","year":"2004","journal-title":"Addict. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1080\/00952990802122580","article-title":"Effect of opium addiction on diabetes","volume":"34","author":"Azod","year":"2008","journal-title":"Am. J. Drug Alcohol. Abuse"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"436","DOI":"10.3389\/fphys.2016.00436","article-title":"The impact of opium consumption on blood glucose, serum lipids and blood pressure, and related mechanisms","volume":"7","author":"Najafipour","year":"2016","journal-title":"Front. Physiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"339","author":"Moher","year":"2009","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Higgins, J.P.T., and Green, S. (2009). Cochrane Handbook for Systematic Reviews of Interventions, Wiley-Blackwell.","DOI":"10.1002\/9780470712184"},{"key":"ref_16","unstructured":"Critical Appraisal Skills Programme (CASP) (2018, June 30). CASP Checklists. Available online: https:\/\/casp-uk.net\/casp-tools-checklists\/."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomized studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_18","first-page":"497","article-title":"Opium consumption and lipid and glucose parameters in diabetic patients with acute coronary syndrome: A survey in northern Iran","volume":"92","author":"Mohammadali","year":"2014","journal-title":"Tunis Med."},{"key":"ref_19","first-page":"1","article-title":"Potential effect of opium consumption on controlling diabetes and some cardiovascular risk factors in diabetic patients","volume":"6","author":"Rahimi","year":"2014","journal-title":"Addict. Health"},{"key":"ref_20","unstructured":"The Nordic Cochrane Centre (2014). Review Manager (RevMan) [Computer Program], The Nordic Cochrane Centre, The Cochrane Collaboration. Version 5.3."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1055\/s-0031-1280017","article-title":"Opium consumption and coronary atherosclerosis in diabetic patients: A propensity score-matched study","volume":"77","author":"Hosseini","year":"2011","journal-title":"Planta Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s00592-010-0243-z","article-title":"Recreational drug abuse in patients hospitalized for diabetic ketosis or diabetic ketoacidosis","volume":"50","author":"Isidro","year":"2013","journal-title":"Acta Diabetol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1111\/j.1445-5994.2011.02653.x","article-title":"Recreational drug use in type 1 diabetes: An invisible accomplice to poor glycaemic control?","volume":"42","author":"Lee","year":"2012","journal-title":"Intern. Med. J."},{"key":"ref_24","first-page":"1","article-title":"Active cocaine use does not increase the likelihood of hyperglycemic crisis","volume":"9","author":"Modzelewski","year":"2017","journal-title":"J. Clin. Transl. Endocrinol."},{"key":"ref_25","first-page":"72","article-title":"Opium consumption challenge and diabetes mellitus control","volume":"3","author":"Rezvanfar","year":"2011","journal-title":"Iran. J. Diabetes Obes. (IJDO)"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S0378-8741(03)00035-7","article-title":"Effect of Catha edulis on plasma glucose and C-peptide in both type 2 diabetics and non-diabetics","volume":"86","year":"2003","journal-title":"J. Ethnopharmacol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1111\/j.1464-5491.2004.01325.x","article-title":"Intravenous drug abuse and Type 1 diabetes: Financial and healthcare implications","volume":"21","author":"Saunders","year":"2004","journal-title":"Diabet. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1001\/archinte.158.16.1799","article-title":"Diabetic ketoacidosis associated with cocaine use","volume":"158","author":"Warner","year":"1998","journal-title":"Arch. Intern. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Gao, L., Matthews, F.E., Sargeant, L.A., Brayne, C., and MRC CFAS (2008). An investigation of the population impact of variation in HbA1c levels in older people in England and Wales: From a population based multi-centre longitudinal study. BMC Public Health, 8.","DOI":"10.1186\/1471-2458-8-54"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"135","DOI":"10.3109\/00952991003734277","article-title":"Opium and heroin alter biochemical parameters of human\u2019s serum","volume":"36","author":"Kouros","year":"2010","journal-title":"Am. J. Drug Alcohol Abuse"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.drugalcdep.2018.01.008","article-title":"Substance use disorders and medical comorbidities among high-need, high-risk patients with diabetes","volume":"186","author":"Wu","year":"2018","journal-title":"Drug Alcohol Depend."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1111\/pme.12835","article-title":"Longitudinal analysis of opioid analgesic dose and diabetes quality of care measures","volume":"16","author":"Gautam","year":"2015","journal-title":"Pain Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1177\/0145721716659149","article-title":"Evaluating substance use and insulin misuse in adolescents with type 1 diabetes","volume":"42","author":"Snyder","year":"2016","journal-title":"Diabetes Educ."},{"key":"ref_34","first-page":"217","article-title":"Does opioid therapy affect quality of care for diabetes mellitus?","volume":"15","author":"Rose","year":"2009","journal-title":"Am. J. Manag. Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/0026-0495(83)90065-3","article-title":"Glucose tolerance and hormonal responses in heroin addicts. A possible role for endogenous opiates in the pathogenesis of non-insulin-dependent diabetes","volume":"32","author":"Passariello","year":"1983","journal-title":"Metabolism"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"108","DOI":"10.3132\/dvdr.2006.013","article-title":"New perspectives on the management of diabetic peripheral neuropathic pain","volume":"3","author":"Jensen","year":"2006","journal-title":"Diabetes Vasc. Dis. Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/12\/2691\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:33:14Z","timestamp":1760196794000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/15\/12\/2691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,29]]},"references-count":36,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["ijerph15122691"],"URL":"https:\/\/doi.org\/10.3390\/ijerph15122691","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,29]]}}}