Recreational drug use in type 1 diabetes: An invisible accomplice to poor glycaemic control?

Department of Endocrinology, St Vincent's Hospital, Sydney, New South Wales, Australia.
Internal Medicine Journal (Impact Factor: 1.64). 02/2012; 42(2):198-202. DOI: 10.1111/j.1445-5994.2011.02653.x
Source: PubMed


Recreational drug use during 'rave' parties is increasingly popular, but the impact of recreational drug use in type 1 diabetes (T1D) is not known. We determined the self-reported pattern and effects of recreational/illicit drug use in Australians with T1D people by inviting people with T1D to participate in an anonymous online/paper survey of drug use, through national radio broadcast and online/hospital advertising. Of the people with T1D who responded to our survey, more than three quarters reported having used recreational/illicit drug, but few people had informed health professionals about drug use. Drug use was associated with worse glycaemic control and higher risk of diabetic ketoacidosis. Medical awareness of common, currently underreported, drug use in young people with T1D is essential. It offers the possibility of helping such patients improve related suboptimal metabolic control.

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    • "While there is a noticeable dearth of literature on the topic specific to children and adolescents with type 1 diabetes (Jaser et al., 2011); the available literature does suggest that youth with type 1 diabetes show both low levels of quality of life (Abolfotouh et al., 2011; Fogel and Weissberg-Benchell, 2010; Perfect et al., 2012) and increased levels of high risk behaviour (Hofer et al., 2009; Jaser et al., 2011; Lee et al., 2012; Martinez-Aguayo et al., 2007; Scaramuzza et al., 2010). For example, recent research has shown that adolescents and young adults with type 1 diabetes engage in illicit drug use at levels significantly higher than their peers (Lee et al., 2012; Scaramuzza et al., 2010). Lee and colleagues (2012) found that 80% of adolescent and 72% of young adult respondents with type 1 diabetes in Australia reported using illicit drugs recreationally. "
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    ABSTRACT: BACKGROUND: There is evidence for increased risk of affective disorders (AD) in adults with type 1 diabetes however, the prevalence and characteristics of AD in young people with the condition is unclear. Comorbid AD in type 1 diabetes is associated with deleterious self-management, sub-optimal clinical indicators, reduced quality of life, poorer physical health, increased complications, increased high risk behaviours in adolescence and young adulthood, and earlier mortality. The present study investigated the prevalence and character of AD in young people with type 1 diabetes. METHODS: The self-report PH-PANAS-C was employed in a cross-sectional, case-control design to identify and differentiate full-syndrome (FS) and subthreshold (St) levels of AD in 53 participants with type 1 diabetes (case) and 54 age-balanced controls (N=107; 7-18 yrs). RESULTS: Case participants reported greater AD than controls. When differentiated, only anxiety was significantly more prevalent. Case participants reported less positive affect, and greater negative affect and autonomic arousal. Further, 1:3 case participants presented with St symptoms of AD. LIMITATIONS: Self-report measures are known to produce moderated responses therefore symptoms may be more severe than reported. There has been some suggestion that responses to somatic items in the PH-PANAS-C may relate to diabetes-specific states rather than affect-related symptoms however, recent evidence has refuted this argument. CONCLUSIONS: AD, particularly anxiety, represents a significant clinical concern in young people with type 1 diabetes both as a disorder in its own right and as a major impediment to primary care and management of the diabetes. The significant dominance of anxiety-related symptoms and prevalence of subthreshold presentation warrant further investigation.
    Journal of Affective Disorders 11/2012; 147(1-3). DOI:10.1016/j.jad.2012.10.006 · 3.38 Impact Factor
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    ABSTRACT: Drug abuse (DA) and addiction is a complex illness, broadly viewed as a neurobiological impairment with genetic and environmental factors that influence its development and manifestation. Abused substances can disrupt the activity of neurons by interacting with many proteins, particularly G-protein coupled receptors (GPCRs). A few medicines that target the central nervous system (CNS) can also modulate DA related proteins, such as GPCRs, which can act in conjunction with the controlled psychoactive substance(s) and increase side effects. To fully explore the molecular interaction networks that underlie DA and to effectively modulate the GPCRs in these networks with small molecules for DA treatment, we built a drug-abuse domain specific chemogenomics knowledgebase (DA-KB) to centralize the reported chemogenomics research information related to DA and CNS disorders in an effort to benefit researchers across a broad range of disciplines. We then focus on the analysis of GPCRs as many of them are closely related with DA. Their distribution in human tissues was also analyzed for the study of side effects caused by abused drugs. We further implement our computational algorithms/tools to explore DA targets, DA mechanisms and pathways involved in polydrug addiction and to explore polypharmacological effects of the GPCR ligands. Finally, the polypharmacology effects of GPCRs-targeted medicines for DA treatment were investigated and such effects can be exploited for the development of drugs with polypharmacophore for DA intervention. The chemogenomics database and the analysis tools will help us better understand the mechanism of drugs abuse and facilitate to design new medications for system pharmacotherapy of DA.
    Frontiers in Pharmacology 02/2014; 5:3. DOI:10.3389/fphar.2014.00003 · 3.80 Impact Factor

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