Marijuana Use and Type 2 Diabetes Mellitus: a Review
Marijuana is used by millions of people, with use likely to increase in the USA because of the trend towards increased decriminalization and legalization. Obesity and diabetes mellitus (DM) rates have increased dramatically in the USA over the past 30 years, with a recent estimate of 29 million individuals with DM. Because there is a plausible link between marijuana use and diabetes due to the known effects of cannabinoids on adipose tissue and glucose/insulin metabolism, it is important to study and understand how marijuana use is related to obesity and diabetes. This paper provides background on the human endocannabinoid system and studies of the association of marijuana use with body mass index/obesity, metabolic syndrome, prediabetes, and diabetes. The studies to date have shown that marijuana use is associated with either lower odds or no difference in the odds of diabetes than non-use.
KeywordsMarijuana Cannabis Diabetes Epidemiology Endocannabinoid
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services: 2014.Google Scholar
- 2.Center for Behavioral Health Statistics and Quality (CBHSQ). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2015. HHS Publication No. SMA 15–4927, NSDUH Series H-50.Google Scholar
- 3.http://www.governing.com/gov-data/state-marijuana-laws-map-medical-recreational.html, accessed 5/28/2016.
- 4.http://www.drugpolicy.org/facts/drug-facts/marijuana/how-marijuana-consumed, accessed 5/28/2016
- 5.Marijuana and Health: Report of a Study by a Committee of the Institute of Medicine, Division of Health Sciences Policy. National Academy Press. Washington, D.C.1982. http://www.nap.edu/read/18942/chapter/1
- 8.Munro S, Thomas KL, Abu-Shaar M. Molecular characterization of a peripheral receptor for cannabinoids. Nature. 1993;365:61–5.Google Scholar
- 13.Côté M, Matias I, Lemieux I, Petrosino S, Alméras N, Després JP, et al. Circulating endocannabinoid levels, abdominal adiposity and related cardiometabolic risk factors in obese men. Int J Obes (Lond). 2007;31(4):692–9.Google Scholar
- 14.Di Marzo V, Côté M, Matias I, Lemieux I, Arsenault BJ, Cartier A, et al. Changes in plasma endocannabinoid levels in viscerally obese men following a 1 year lifestyle modification programme and waist circumference reduction: associations with changes in metabolic risk factors. Diabetologia. 2009;52(2):213–7. doi:10.1007/s00125-008-1178-6.CrossRefPubMedGoogle Scholar
- 22.Yankey BN, Strasser S, Okosun IS. A cross-sectional analysis of the association between marijuana and cigarette smoking with metabolic syndrome among adults in the United States. Diabetes Metab Syndr. 2016;10(2 Suppl 1):S89–95. doi:10.1016/j.dsx.2016.03.001.
- 23.Vidot DC, Prado G, Hlaing WM, Florez HJ, Arheart KL, Messiah SE. Metabolic Syndrome among marijuana users in the United States: an analysis of National Health and Nutrition Examination Survey data. Am J Med. 2016;129(2):173–9. doi:10.1016/j.amjmed.2015.10.019.
- 24.••Bancks MP, Pletcher MJ, Kertesz SG, Sidney S, Rana JS, Schreiner PJ. Marijuana use and risk of prediabetes and diabetes by middle adulthood: the Coronary Artery Risk Development in Young Adults (CARDIA) study. Diabetologia. 2015;58(12):2736–44. doi:10.1007/s00125-015-3740-3. This is the only study of the relationship of marijuana use with diabetes that has a longitudinal component and also the only one with an analysis of marijuana use and prediabetes.CrossRefPubMedGoogle Scholar
- 25.Rajavashisth TB, Shaheen M, Norris KC, Pan D, Sinha SK, Ortega J, et al. Decreased prevalence of diabetes in marijuana users: cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) III. BMJ Open. 2012;2:e000494. doi:10.1136/bmjopen-2011-000494.CrossRefPubMedPubMedCentralGoogle Scholar
- 26.•Alshaarawy O, Anthony JC. Cannabis smoking and diabetes mellitus: results from meta-analysis with eight independent replication samples. Epidemiology. 2015;26(4):597–600. doi:10.1097/EDE.0000000000000314. This is the most recent published study of the relationship of marijuana use with diabetes and includes a meta-analysis of 8 separate national surveys from 2 different sources.CrossRefPubMedPubMedCentralGoogle Scholar