Table 3 Exposure characteristics and outcomes

Akturk, 2019 [21]

Group 1: multiple

 Smoking: 97 (72.4%)

 Edible: 65 (48.5%)

 Vaporization: 54 (40.3%)

 Other: 19 (14.2%)

Group 2: not applicable (non-users)

Group 1:

 < 1 time/month: 48 (35.8%)

 2–4 times/month: 14 (10.4%)

 2–3 times/week: 17 (12.7%)

 > 4 times/week: 54 (40.3%)

Group 2: not applicable (non-users)

Outcome 1: risk of DKA

Cannabis use within the previous 12 months was associated with an increased risk of DKA compared with no cannabis use (entire cohort OR 1.98, 95% CI 1.01–3.91)

Outcome 2: HbA1c mean level

Group 1: HbA1c: 8.4% (SD  2.0) [p < .01]

Cannabis users had a mean 0.41% higher HbA1c level than nonusers when adjusted for insulin delivery method, income and age (95% CI, 0.38-0.43)

Group 2: HbA1c: 7.6% (SD  1.6) [p < .01]

Outcome 3: episodes of severe hypoglycemia

Group 1: 15.6% (21 of 134) [p = .17]

Group 2: 20.3% (64 of 316) [p = .17]

Helgeson, 2016 [22]

Inhaled; smoked cannabis

–

Outcome 1: HbA1c level

Average HbA1c was 8.8% (12% with HbA1c > 11%) [at baseline]

Smoking cannabis was related to higher HbA1c (r = .30, p < 0.01)

Outcome 2: albumin-to-creatinine ratio

Smoking cannabis was related to higher uACR (r = .22, p < 0.05)

Hogendorf, 2016 [23]

–

–

Outcome 1: glycemic control

“Half of the [T1D] patients (53%) had HbA1c levels above 8% [at baseline]; lifetime and last 12-month use of cannabis were associated with poorer glycemic control (HbA1c ≥ 8%), p < 0.01 and p < 0.02, respectively.”

Outcome 2: glycemic control

HbA1c  of 6-8%: 14/89 tried cannabis

HbA1c of 8-10% : 11/62

HbA1c of 10-12%: 9/30

HbA1c >12%: 4/8 tried cannabis (p = 0.03)

Thurheimer-Cacciotti, 2017 [24]

–

–

Outcome 1: glycemic control

“Women who reported multiple (> 1) risk-taking behaviours were more likely to have a higher HbA1c (> 8%) compared to women who reported 0–1 risky behaviour (RR = 1.29, 95% CI 0.605–2.742).”

Winhusen, 2018 [25]

–

–

Outcome 1: diabetic renal disease

Cannabis use was associated with a statistically significant increased risk of diabetic renal disease

Outcome 2: myocardial infarction

Cannabis use was associated with a statistically significant increased risk of myocardial infarction

Outcome 3: peripheral arterial occlusion

Cannabis use was associated with a statistically significant increased risk of peripheral arterial occlusion

Outcome 4: neuropathy

Cannabis use was not associated with a statistically significant increased risk of neuropathy

Outcome 5: cerebrovascular accident

Cannabis use was not associated with a statistically significant increased risk of cerebrovascular accident

Wisk, 2018 [26]

–

–

Outcome 1: diabetes self-management

“Much like their peers, college students with T1D frequently consume alcohol and cannabis; those with T1D who use more frequently experience higher HbA1c and are less likely to achieve glycemic targets, independent of blood glucose testing and diabetes burden.”

Outcome 2: most recent HbA1c level

“Multivariable analyses revealed that those who drank 3+ days in the past month (50.7% of sample) had significantly higher HbA1c (by 0.63%, p < 0.01) and were significantly more likely to be above recommended glycemic targets (OR 3.08, 95% CI 1.59–5.98). Similar results were observed for cannabis and cigarettes.”