Cannabis Use as Risk or Protection for Type 2 Diabetes: A Longitudinal Study of 18 000 Swedish Men and Women

Abstract

Aims. Whether or not cannabis use may increase or decrease the risk of type 2 diabetes is not clear. We analyzed the association between cannabis and subsequent type 2 diabetes and if a potential positive or reverse association persisted after controlling for potential confounders. Methods. In this population-based cohort study, 17,967 Swedish men and women (aged 18–84 years), who answered an extensive questionnaire in 2002 (including questions on cannabis use), were followed up for new cases of type 2 diabetes (n = 608) by questionnaire (in 2010) and in health registers during 2003–2011. Odds ratios (ORs) with 95% CIs were estimated in a multiple logistic regression analysis. Potential confounders included age, sex, BMI, physical inactivity, smoking, alcohol use, and occupational position. Results. The crude association showed that cannabis users had a reduced risk of type 2 diabetes OR = 0.68 (95% CIs: 0.47–0.99). However, this inverse association attenuated to OR = 0.94 (95% CIs: 0.63–1.39) after adjusting for age. Conclusions. The present study suggests that there is no association between cannabis use and subsequent type 2 diabetes after controlling for age. To make more robust conclusions prospective studies, with longer periods of follow-up and more detailed information about cannabis use, are needed.

Theoretical Explanation for Reduced Body Mass Index and Obesity Rates in <em>Cannabis</em> Users

“…The percent of each group that consumed Cannabis was negatively and linearly related to the BMI of the group (R 2 = 0.96). Danielsson et al (Danielsson et al, 2016) also reported decreased rates of overweight (BMI > 24.9) in Cannabis users but did not provide numerical data for BMI of the two groups. Thus, of eleven studies reporting data on the relationship between Cannabis use and BMI, nine showed a significant negative relationship between Cannabis use and BMI while the remaining two either reported lower BMI values in Cannabis users than non-users that did not reach statistical significance, or failed to provide statistical analyses (Table 1).…”

“…In contrast, analysis of data from the CARDIA data set failed to detect this relationship (Bancks et al, 2015). Daniellson et al (Danielsson et al, 2016) found decreased rates of DM in Cannabis users in a dataset of Swedish conscripts (OR 0.74), but unlike the studies from the NHANES data set this effect was no longer significant after adjustment for age (AOR 0.74 prior to adjustment, 0.94 after adjustment).…”

“…According to the theory established in the current paper, populations with diets characterized by a high omega-6/omega-3 ratio will see significantly larger health improvements from Cannabis use than those eating diets with more moderate ratios of omega-6/omega-3 FAs. This may explain some of the inconsistencies in the data on the metabolic impact of Cannabis use; for example, Cannabis use by Swedish populations (Danielsson et al, 2016, Cerdá et al, 2016 may not have the same health impacts as Cannabis use by Americans due to the different dietary backgrounds and obesity rates of these populations. Cannabis use in the United States appears to provide significant public health benefits due to partial or complete reversal of the metabolic dysregulation caused by the strongly elevated omega-6/omega-3 ratio of the American diet.…”

“…26.9 (831) < 0.0001 (Danielsson et al, 2016) Numerical data not provided; user BMI < non-user Not provided (Warren et al, 2005) Numerical data not provided; lower BMI groups contain more Cannabis users, R 2 = 0.96 < 0.02 Table 1. Published values of BMI for Cannabis users and non-users.…”

Associations Between Marijuana Use and Cardiovascular Risk Factors and Outcomes

“…A greater risk for prediabetes (hazard ratio [HR], 1.39 [95% CI, 1.13 to 1.71]) was identified among participants who reported using marijuana 100 or more times during follow-up compared with nonusers. The final prospective study (high ROB) followed 18 000 Swedish men and women aged 18 to 84 years over 10 years but assessed marijuana exposure only once, at baseline (27). Measures of socioeconomic factors, diet, or other drug use at baseline were limited.…”