Objective To determine the association between diabetes mellitus (DM) and marijuana use.
Design Cross-sectional study.
Setting Data 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.
Participants The 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 measures OR for DM associated with marijuana use adjusted for potential confounding variables (ie, odds of DM in marijuana users compared with non-marijuana users).
Results Marijuana 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).
Conclusions Marijuana use was independently associated with a lower prevalence of DM. Further studies are needed to show a direct effect of marijuana on DM.
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To cite: Rajavashisth TB, Shaheen M, Norris KC, 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
Contributors TBR conceived and designed project, and drafted and reviewed manuscript. MS designed project, drafted and reviewed manuscript, analysed and interpreted data, provided statistical expertise and collected data. KCN drafted and reviewed manuscript. DP analysed data, provided statistical expertise and collected data. SKS drafted manuscript. JO drafted manuscript. TCF conceived and designed project, drafted and reviewed manuscript, provided statistical expertise, analysed and interpreted data. MS and TCF are guarantors.
Funding This work was supported in part by the following grants: R24DA017298, R01 HL59180, U54 RR026138, P20 MD000182, S06 GM068510, U54 HD41748 and R25 RR019488.
Competing interests All authors have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare the following: TBR is the owner of Omics Biotechnology, Inc, a company with an interest in using modifications of cannabinoids-mediated cell signalling to treat diabetes mellitus and other diseases of inflammation. TBR was not involved in the data collection or statistical analyses. MS, KCN, DP, SKS, JO and TCF have no relationships with companies that might have an interest in the submitted work in the previous 3 years. TBR, MS, KCN, DP, SKS, JO and TCF have no non-financial interests that may be relevant to the submitted work and their spouses, partners or children have no financial relationships that may be relevant to the submitted work.
Ethics approval This study was exempt from Institutional Review Board (IRB) review. This exemption complied with the policy of the Charles Drew University IRB related to the use of publically available data for research and publication.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The NHANES data are publically available. Statistical code and working data set are available from the corresponding author at .