<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1137-6627</journal-id>
<journal-title><![CDATA[Anales del Sistema Sanitario de Navarra]]></journal-title>
<abbrev-journal-title><![CDATA[Anales Sis San Navarra]]></abbrev-journal-title>
<issn>1137-6627</issn>
<publisher>
<publisher-name><![CDATA[Gobierno de Navarra. Departamento de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1137-66272020000100010</article-id>
<article-id pub-id-type="doi">10.23938/assn.0748</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Intoxicación por Spice e hiperglucemia]]></article-title>
<article-title xml:lang="en"><![CDATA[Spice intoxication and hyperglycemia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Elena-González]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cuadros-Tito]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Esteban-Gutiérrez]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Príncipe de Asturias Servicio de Medicina Interna ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario Príncipe de Asturias Servicio de Urgencias ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2020</year>
</pub-date>
<volume>43</volume>
<numero>1</numero>
<fpage>87</fpage>
<lpage>91</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1137-66272020000100010&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1137-66272020000100010&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1137-66272020000100010&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Presentamos un caso de hiperglucemia secundaria a intoxicación por cannabinoides sintéticos (CS). Los CS son drogas de abuso con efectos similares a la marihuana pero con diferente estructura química, lo que evita su detección con los test de drogas utilizados habitualmente, dificultando su diagnóstico. Entre los posibles efectos secundarios de su uso se encuentra la hiperglucemia. Su consumo debe sospecharse ante hiperglucemias no explicables por otra causa, especialmente en pacientes jóvenes que presenten, además, otra clínica compatible con consumo de CS, tales como agitación, cuadro confusional o psicosis; debería interrogarse al paciente sobre su uso. Es importante, además, que la población diabética conozca los efectos secundarios de los cannabinoides sintéticos, para evitar su consumo por un sector de la población especialmente vulnerable a las consecuencias de su empleo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract We present a case of intoxication by synthetic cannabinoids (SC). SC are substances of abuse with similar effects to Marijuana but with a different chemical structure, which avoids its detectability by regular drug tests, making diagnosis difficult. Among the possible side effects of their use is hyperglycemia. Their presence should be suspected in cases of hyperglycemia that cannot be explained by any other cause, especially in young patients presenting further symptoms of a clinical picture suggestive of SC consumption such as agitation, confusional symptoms or psychosis; the patient should be questioned about their use. It is important that the diabetic population knows the side effects of synthetic cannabinoids to avoid their consumption, as it is a sector of the population especially vulnerable to the consequences of their use.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cannabinoides Sintéticos]]></kwd>
<kwd lng="es"><![CDATA[Spice]]></kwd>
<kwd lng="es"><![CDATA[Hiperglucemia]]></kwd>
<kwd lng="es"><![CDATA[Intoxicación Aguda]]></kwd>
<kwd lng="es"><![CDATA[Abuso de drogas]]></kwd>
<kwd lng="en"><![CDATA[Synthetic cannabinoids]]></kwd>
<kwd lng="en"><![CDATA[Spice]]></kwd>
<kwd lng="en"><![CDATA[Hyperglycemia]]></kwd>
<kwd lng="en"><![CDATA[Acute intoxication]]></kwd>
<kwd lng="en"><![CDATA[Drug abuse]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA["Spice" girls: Synthetic cannabinoid intoxication]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schneir]]></surname>
<given-names><![CDATA[AB]]></given-names>
</name>
<name>
<surname><![CDATA[Cullen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ly]]></surname>
<given-names><![CDATA[BT]]></given-names>
</name>
</person-group>
<source><![CDATA[J Emerg Med]]></source>
<year>2011</year>
<volume>40</volume>
<page-range>296-9</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Spice: a new "legal" herbal mixture abused by young active duty military personnel]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bebarta]]></surname>
<given-names><![CDATA[VS]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Varney]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
</person-group>
<source><![CDATA[Subst Abus]]></source>
<year>2012</year>
<volume>33</volume>
<page-range>191-4</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Emergent drugs (I) smart drugs]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Burillo-Putze]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[BC]]></given-names>
</name>
<name>
<surname><![CDATA[Pazos]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Mas]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[Miró]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Puiguriguer]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[An Sist Sanit Navar]]></source>
<year>2011</year>
<volume>34</volume>
<page-range>263-74</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Detección e identificación de cannabinoides sintéticos en muestras sólidas y biológicas]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martínez-Galdámez]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Llorente Ballesteros]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Urquía Grande]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[López Colón]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<source><![CDATA[Sanid Mil]]></source>
<year>2019</year>
<volume>75</volume>
<page-range>14-8</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Orden SSI/748/2016, de 11 de mayo, por la que se incluyen determinadas sustancias en el anexo I del Real Decreto 2829/1977, de 6 de octubre, por el que se regulan las sustancias y preparados medicinales psicotrópicos, así como la fiscalización e inspección de su fabricación, distribución, prescripción y dispensación y se transfiere de lista de control la sustancia 1-benzilpiperazina (BZP)]]></article-title>
<collab>Ministerio de Sanidad, Consumo y Bienestar Social. Gobierno de España</collab>
<source><![CDATA[Boletín Oficial del Estado]]></source>
<year>2016</year>
<numero>120</numero>
<issue>120</issue>
<page-range>32818-20</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Orden SCB/770/2018, de 12 de julio, por la que se incluyen nuevas sustancias en el anexo 1 del Real Decreto 2829/1977, de 6 de octubre, por el que se regulan las sustancias y preparados medicinales psicotrópicos, así como la fiscalización e inspección de su fabricación, distribución, prescripción y dispensación]]></article-title>
<collab>Ministerio de Sanidad, Consumo y Bienestar Social. Gobierno de España</collab>
<source><![CDATA[Boletín Oficial del Estado]]></source>
<year>2018</year>
<numero>175</numero>
<issue>175</issue>
<page-range>73005-6</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="">
<collab>Asociación Bienestar y Desarrollo</collab>
<source><![CDATA[Programa Energy Control. Informe "Legal Highs" en España]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Spice drugs are more than a harmless herbal blends A review of the pharmacology and toxicology of synthetic cannabinoids]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Seely]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Lapoint]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Moran]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Fattore]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Prog Neuropsychopharmacol Biol Psychiatry]]></source>
<year>2012</year>
<volume>39</volume>
<page-range>234-343</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The cannabinoid CB1 receptor is expressed in pancreatic d-cells]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tharp]]></surname>
<given-names><![CDATA[WG]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[YH]]></given-names>
</name>
<name>
<surname><![CDATA[Maple]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Pratley]]></surname>
<given-names><![CDATA[RE]]></given-names>
</name>
</person-group>
<source><![CDATA[Biochem Biophys Res Commun]]></source>
<year>2008</year>
<volume>372</volume>
<page-range>595-600</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The effects of cannabinoids on the endocrine system]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Borowska]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Czarnywojtek]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sawicka-Gutaj]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Kl]]></surname>
<given-names><![CDATA[Wolinski]]></given-names>
</name>
<name>
<surname><![CDATA[Plazinska]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Mikolajczak]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<source><![CDATA[Endokrynol Pol]]></source>
<year>2018</year>
<volume>69</volume>
<page-range>705-19</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Human metabolites of synthetic cannabinoids JWH-018 and JWH-073 bind with high affinity and act as potent agonists at cannabinoid type-2 receptors]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rajasekaran]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Brents]]></surname>
<given-names><![CDATA[LK]]></given-names>
</name>
<name>
<surname><![CDATA[Franks]]></surname>
<given-names><![CDATA[LN]]></given-names>
</name>
<name>
<surname><![CDATA[Moran]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Prather]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
</person-group>
<source><![CDATA[Toxicol Appl Pharmacol]]></source>
<year>2013</year>
<volume>269</volume>
<page-range>100-8</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Overexpresion of cannabinoid CB2 receptor in the brain induces hyperglycaemia and a lean phenotype in adult mice]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Romero-Zerbo]]></surname>
<given-names><![CDATA[SY]]></given-names>
</name>
<name>
<surname><![CDATA[García-Gutiérrez]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Suárez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rivera]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Ruz-Maldonado]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Vida]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[J Neuroendocrinol]]></source>
<year>2012</year>
<volume>24</volume>
</nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Synthetic cannabinoids: epidemiology, pharmacodynamics, and clinical implications]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castaneto]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[Gorelick]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
<name>
<surname><![CDATA[Desrosiers]]></surname>
<given-names><![CDATA[NA]]></given-names>
</name>
<name>
<surname><![CDATA[Hartman]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Pirard]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Huestis]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<source><![CDATA[Drug Alcohol Depend]]></source>
<year>2014</year>
<volume>144</volume>
<page-range>12-41</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Notes from the field: Severe illness associated with synthetic cannabinoid use - Brunswick, Georgia, 2013]]></article-title>
<collab>Centers for Disease Control and Prevention</collab>
<source><![CDATA[Morbidity and Mortality Weekly Report]]></source>
<year>2013</year>
<volume>62</volume>
<page-range>939</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Death due to diabetic ketoacidosis Induction by the consumption of synthetic cannabinoids?]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hess]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Stockhausen]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Kernbach-Wighton]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Madea]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<source><![CDATA[Forensic Sci Int]]></source>
<year>2015</year>
<volume>257</volume>
<page-range>e6-1</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
