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Brief Report

Cannabis Smoking and Diabetes Mellitus

Results from Meta-analysis with Eight Independent Replication Samples

Alshaarawy, Omayma; Anthony, James C.

doi: 10.1097/EDE.0000000000000314
Chronic Disease
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SDC

Background: In preclinical animal studies, evidence links cannabis with hyperphagia, obesity, and insulin resistance. Epidemiologic data, however, suggest an inverse cannabis smoking–diabetes mellitus association. Here, we offer epidemiologic estimates from eight independent replications from (1) the National Health and Nutrition Examination Surveys, and (2) the National Surveys on Drug Use and Health (2005–2012).

Methods: For each national survey participant, computer-assisted self-interviews assess cannabis smoking and physician-diagnosed diabetes mellitus; the National Health and Nutrition Examination Surveys provide additional biomarker values and a composite diabetes diagnosis. Regression analyses produce estimates of cannabis smoking–diabetes associations. Meta-analyses summarize the replication estimates.

Results: Recently active cannabis smoking and diabetes mellitus are inversely associated. The meta-analytic summary odds ratio is 0.7 (95% confidence interval = 0.6, 0.8).

Conclusions: Current evidence is too weak for causal inference, but there now is a more stable evidence base for new lines of clinical translational research on a possibly protective (or spurious) cannabis smoking–diabetes mellitus association suggested in prior research.

From the Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI.

Submitted 18 September 2014; accepted 31 March 2015.

This work is completed during OA’s first year of postdoctoral epidemiology fellowship, supported by the National Institute on Drug Abuse (T32DA021129) and JCA’s NIDA Senior Scientist Award (K05DA015799), and by Michigan State University. The content is the sole responsibility of the authors and does not necessarily represent the official views of Michigan State University, the National Institute on Drug Abuse, or the National Institutes of Health.

The authors report no conflicts of interests.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article (www.epidem.com). This content is not peer-reviewed or copy-edited; it is the sole responsibility of the authors.

Correspondence: James C. Anthony, Professor, Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48823. E-mail: janthony@msu.edu.

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