Decreased prevalence of diabetes in marijuana users: cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) III

Abstract

ObjectiveTo determine the association between diabetes mellitus (DM) and marijuana use.DesignCross-sectional study.SettingData from the National Health and Nutrition Examination Survey (NHANES III, 1988–1994) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention.ParticipantsThe study included participants of the NHANES III, a nationally representative sample of the US population. The total analytic sample was 10 896 adults. The study included four groups (n=10 896): non-marijuana users (61.0%), past marijuana users (30.7%), light (one to four times/month) (5.0%) and heavy (more than five times/month) current marijuana users (3.3%). DM was defined based on self-report or abnormal glycaemic parameters. We analysed data related to demographics, body mass index, smoking status, alcohol use, total serum cholesterol, high-density lipoprotein, triglyceride, serum 25-hydroxy vitamin D, plasma haemoglobin A1c, fasting plasma glucose level and the serum levels of C reactive protein and four additional inflammatory markers as related to marijuana use.Main outcome measuresOR for DM associated with marijuana use adjusted for potential confounding variables (ie, odds of DM in marijuana users compared with non-marijuana users).ResultsMarijuana users had a lower age-adjusted prevalence of DM compared to non-marijuana users (OR 0.42, 95% CI 0.33 to 0.55; p<0.0001). The prevalence of elevated C reactive protein (>0.5 mg/dl) was significantly higher (p<0.0001) among non-marijuana users (18.9%) than among past (12.7%) or current light (15.8%) or heavy (9.2%) users. In a robust multivariate model controlling for socio-demographic factors, laboratory values and comorbidity, the lower odds of DM among marijuana users was significant (adjusted OR 0.36, 95% CI 0.24 to 0.55; p<0.0001).ConclusionsMarijuana use was independently associated with a lower prevalence of DM. Further studies are needed to show a direct effect of marijuana on DM.

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

“…Of those studies reporting significant negative correlations, two reported that longer duration of Cannabis use was associated with reduced BMI , Rajavashisth et al, 2012.…”

“…There is some evidence for this, but results are inconsistent. Multiple studies have reported in Cannabis users reduced rates of diabetes mellitus, insulin insensitivity, or metabolic syndrome in fully adjusted models including age (Rajavashisth et al, 2012, Ngueta et al, 2015, Alshaarawy and Anthony, 2015, Penner et al, 2013, Thompson and Hay, 2015, Waterreus et al, 2016. Yankey et al (Yankey et al, 2016) also reported decreased DM rates (AOR 0.42) that did not reach statistical significance (95% CI = 0.13 -1.36).…”

“…Our theory suggests that the "high" that occurs upon CB1R stimulation with THC may be a necessary accompaniment to weight loss, because downregulation of CB1R is required for reduced BMI and it is not yet clear whether microdosing will cause downregulation. However, weekly or biweekly Cannabis use may be sufficient as significant decreases in BMI are observed at weekly usage rates (Rajavashisth et al, 2012).…”

“…Proposed explanations for reduced BMI in Cannabis users include substitution of Cannabis for food in brain reward pathways (Warren et al, 2005). Pagotta et al (Pagotto et al, 2006) suggested that the sedative effects of high doses of Cannabis could reduce food consumption, but Rajavashiseth et al (Rajavashisth et al, 2012) observed detectable effects on BMI at usage rates of four times or less per month (25% of non-users were obese, whereas 16% of people who used Cannabis 1 -4 times/month were obese, P < 0.001). Sabia et al (Sabia et al, 2017) suggested that reduced alcohol use by younger users, and increased physical activity of older users upon initiating medical marijuana use, may be responsible for the observed decrease in BMI.…”

Is Marijuana Beneficial for Prevention and Treatment of Diabetes?

“…In 2012, Rajavashisth and coworkers [25] analyzed data collected by the National Health and Nutrition Examination Survey and found that current light marijuana users have lower diabetes prevalence than current heavy users and past marijuana users, Figure 2. Also, all marijuana users (past or current) are less likely to be diagnosed as diabetes compared to non-marijuana users ( Figure 2) after adjustment with confronting factors such as age, race and alcohol use.…”