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Table 3 Exposure characteristics and outcomes

From: The effects of recreational cannabis use on glycemic outcomes and self-management behaviours in people with type 1 and type 2 diabetes: a rapid review

First author, year Consumption method; description Quantity and frequency consumed Outcome name Results
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.”
  1. OR odds ratio, RR relative risk, p p value, SD standard deviation, 95% CI 95% confidence interval, DKA diabetic ketoacidosis, HbA1c glycated hemoglobin, uACR urinary albumin/creatinine ratio, T1D type 1 diabetes