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is marijuana good for diabetes

Can Medical Marijuana Help Treat Type 2 Diabetes?

While research on the risks and benefits of medical marijuana for people with diabetes is only preliminary, some studies suggest certain potential effects that may be worth further scientific exploration.

Although research on marijuana for medicinal purposes is limited and the Food and Drug Administration (FDA) has not approved the drug as a standard of care, 29 states and Washington, DC, have legalized medical marijuana. That legislation has passed at a time when some research, which has mostly been observational and conducted in animals, links marijuana use to improved symptoms associated with HIV, multiple sclerosis, chronic pain, and mental disorders.

But what do researchers say about using marijuana to help treat or prevent diabetes? Suffice it to say, studies suggest you shouldn’t light up just yet.

Can Cannabis Help Prevent Diabetes?

The marijuana plant contains chemicals called cannabinoids that have a range of effects, including increased appetite and diminished pain and inflammation. That all sounds great, but what’s really going on?

Even though some preliminary research suggests medical marijuana may help improve glucose control and insulin resistance, doctors across the board aren’t quick to recommend marijuana for diabetes prevention. That’s because most of the studies haven’t met the gold standard for medical research: Medical marijuana hasn’t been analyzed in large, randomized, controlled studies in human subjects with type 2 diabetes. Such studies reduce the risk of bias in study authors, and provide the most reliable evidence we have for a cause-and-effect relationship between two factors (in this case, medical marijuana and diabetes) rather than just a correlative link, which observational studies draw.

That said, those observational studies may offer clues about how cannabis may affect diabetes. For example, a study published in July 2013 in The American Journal of Medicine looked at nearly 600 adult men and women currently using marijuana and about 2,000 who had used it in the past; after fasting overnight, they had their blood drawn and were screened for other health factors, such as blood pressure, body mass index (BMI), and waist circumference. Compared with those participants who had never used marijuana, participants who were current users had 16 and 17 percent lower fasting insulin levels and measures of insulin resistance, respectively. They were also more likely to have smaller waistlines.

On the basis of their preliminary findings, the authors noted that specific cannabinoid receptors in the body may help improve insulin sensitivity. They were also interested in the association between using the drug and having a smaller waist circumference. Those who use cannabis eat more calories on average, the authors pointed out, and paradoxically also tend to have lower BMIs. One possible explanation: Previous research had found that when marijuana was given to obese mice, the rodents slimmed down and had better functioning of their beta cells, which produce insulin. And finally, the drug may also influence a protein called adiponectin, which has been linked with improved insulin sensitivity.

Results from the latter animal study seem to support the conclusion of an observational cross-sectional study published in January 2012 in BMJ Open. That research looked at about 11,000 participants of the NHANES III study, which sampled the United States adult population and drew an association between use of cannabis and a 58 percent reduced risk of developing diabetes mellitus (the term includes both type 1 and 2) compared with those who don’t dabble in the drug. Although researchers note that more studies would need to be conducted to prove a causal effect, they theorized that the anti-inflammatory properties of cannabinoids may have led to the improved health outcomes in participants.

A more recent study, published in December 2015 in Diabetologia, found an entirely different association between marijuana use and diabetes risk. In that research, current young adult users were 65 percent more likely to develop prediabetes by middle age versus never-users. Keep in mind that with both these studies, data relied on people reporting their marijuana habits accurately and honestly, which may have skewed the results.

Because the association was murky, a team of Swedish researchers conducted their own research. The study, published in October 2016 in the Journal of Diabetes Research, looked at 18,000 men and women and found no link between using the drug and developing diabetes after adjusting for age between people who used cannabis and abstainers.

Can Cannabis Help Control Diabetes?

While studies investigating marijuana as a diabetes prevention tool have not been conclusive, one study suggests the drug may be used to help relieve diabetes symptoms; researchers note those findings are also preliminary.

The research, which was published in July 2015 in the Journal of Pain, found that patients suffering from a condition called diabetic neuropathy, or painful nerve damage due to chronic high blood sugar, may lessen their discomfort by inhaling marijuana. Cannabinoid receptors located in the nervous system across the spinal cord and brain appear to work on multiple planes to relieve pain, including decreasing the excitability of receptors, reducing transmission of pain signals in the brain, and inhibiting discomfort down the spinal cord.

Although the study was conducted in humans, and was randomized, controlled, and double-blinded, it was small — involving only 16 participants. Plus, one study doesn’t mean marijuana is safe to use for this purpose, says one of its authors, Mark Wallace, MD, the chair of the division of pain medicine at the University of California in San Diego.

Because most studies are observational and those that are randomized and controlled are small, results on the relationship cannabis may have to diabetes aren’t conclusive. That’s why more rigorous, high-quality research in humans is needed.

Barriers to More Research

But before a definitive conclusion is reached, there are several barriers stalling medical marijuana research, says Melanie Elliott, PhD, an instructor in the department of neurosurgery at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, who studies cannabinoids as a therapy for traumatic brain injuries, inflammatory conditions, and pain.

One hurdle is the regulatory steps that researchers have to pass. Marijuana is still considered a Schedule I controlled substance, meaning it has a high potential for abuse and no accepted medical use. Heroin and ecstasy also fall into this category. “Because of this, there are federal and local regulations that are pretty discouraging to researchers,” says Elliott, who adds that university regulations and institutional reviews are also required. “There are many tiers of review, which become time-consuming and cost money for researchers,” she explains.

The supply of cannabis for research is another problem. Medical dispensaries offer a variety of strains all grown to have different properties, as well as different products, like extracts, edibles, oils, and cigarettes. As Elliott points out, the only source of medical cannabis for government-backed research must go through the National Institute on Drug Abuse (NIDA) and come from farms at a single U.S. higher-education institute, the University of Mississippi.

“As researchers, we don’t have the diversity of cannabinoid strains and products that are available to patients from dispensaries,” she says. Some patients may prefer an edible, for instance, but under current law, researchers can’t study edibles in a government-backed study. A study in which people with diabetes smoke marijuana isn’t ideal, because it would likely lead to cardiorespiratory problems, but for research on medical marijuana as a whole, this limitation is problematic. “It’s important to know what you’re getting as a patient,” she notes. She adds that some researchers say a good marijuana placebo is lacking.

In large part as a result of these barriers, studies that show an association — and conflicting studies, at that — are the current mainstay of the research in this field.

What Clinicians Are Saying

Clinicians agree that more data is needed.

“This research is in its infancy. As far as using marijuana medicinally to improve measures of metabolism or diabetes, there are far more unknowns than knowns, and it’s way too early to make a recommendation to use cannabis,” says Troy Donahoo, MD, an associate professor in the division of endocrinology, diabetes, and metabolism at the University of Florida in Gainesville, who has studied the effect of marijuana use following bariatric surgery. Donahoo was previously at the University of Colorado in Denver, where he saw many patients with diabetes and obesity who used cannabis recreationally or medicinally for anxiety, sleep, or pain control.

He notes that one thing clinicians agree on is that strains of marijuana that produce a feeling of highness — many of which are recreational — wouldn’t be advisable for people with diabetes because they tend to increase appetite. For people with diabetes, strict diet and weight management is crucial to help regulate blood sugar levels and increase insulin sensitivity.

What do doctors also know? Behavior changes like a healthy diet and more physical activity, as well as approved medications for weight loss and diabetes, have proven benefits to halt the development and progression of the disease. “We know the risks and benefits to these,” he says. That makes these approaches far more preferable than medical marijuana for physicians to recommend.

Next Steps for Researchers and Clinicians

Although medical marijuana legislation has passed in more states, many traditional physicians who rely on research and official U.S. medical guidelines continue to have, like patients, only a partial picture of the drug.

“Part of the challenge is that many physicians still have a very low understanding of marijuana and its potential benefits, and I think they often overestimate the risks. While I do believe some components of cannabis can have beneficial effects, we don’t have the full picture to recommend it,” Dr. Donahoo says.

Though the research that’s needed is slow in coming, things are looking up, says Elliott. Last summer, NIDA called out to researchers to express their needs in better studying medical marijuana. There’s hope that, in the future, these changes will be made to open up research possibilities.

Until that happens, don’t be afraid to tell your physician if you’re using marijuana in any way. “I believe it’s important to have an open relationship with your provider, so they can get the full picture of your care,” Donahoo says.

For more on how cannabis may play a role in treating type 2 diabetes, check out Diabetes Daily’s article “CBD Oil and Diabetes: What You Need to Know”!

Medical research on marijuana and diabetes is still in its early stages. Here’s what scientists know so far.

Cannabis and Diabetes

Cannabis, or marijuana, is a drug derived from the cannabis plant that is used for recreational use, medicinal purposes and religious or spiritual rites.

Cannabis plants produce a unique family of compounds called cannabinoids. Of these, the major psychoactive (brain function-affecting) compound is tetrahydrocannabinol (THC).

Marijuana contains high levels of THC, as well as other psychoactive chemicals, which produce the ‘high’ users feel when inhaling or ingesting it.

Two other compounds, tetrahydrocannabivarin (THCV) and cannabidiol (CBD) have been shown to have benefits for blood sugar control and metabolism in diabetes studies.

Legalisation on the NHS

On 1 November 2018 medical cannabis products were made available on the NHS for some people in the UK.

Treatments can only be prescribed by specialist doctors in a limited number of circumstances and not by GPs.

The treatments will contain varying quantities of THC and CBD. Treatments will include pills, capsules and oils but smoking cannabis will not be prescribed.

People who stand to benefit will be children with rare, severe forms of epilepsy, adults with vomiting or nausea caused by chemotherapy, and adults with muscle stiffness caused by multiple sclerosis.

History of cannabis

Cannabis has been used by humans for thousands of years, with the earliest record of its use dating back to the 3rd millennium BC.

It is indigenous to Central and South Asia, and is believed to of been used by many ancient civilizations, particularly as a form of medicine or herbal therapy.

Cannabis and its effect on diabetes

There is growing research investigating cannabis use and the effects on diabetes.

Possible benefits of cannabis

A number of animal-based studies and some human studies have highlighted a number of potential health benefits of cannabis for diabetes.

Research by the American Alliance for Medical Cannabis (AAMC) has suggested that cannabis can help:

  • Stabilise blood sugars – a large body of anecdotal evidence is building among people with diabetes to support this.
  • Suppress some of the arterial inflammation commonly experienced by people with diabetes, which can lead to cardiovascular disease
  • Prevent nerve inflammation and ease the pain of neuropathy – the most common complication of diabetes – by stimulating receptors in the body and brain.
  • Lower blood pressure over time, which can help reduce the risk of heart disease and other diabetes complications
  • Keep blood vessels open and improve circulation.
  • Relieve muscle cramps and the pain of gastrointestinal (GI) disorders
  • Be used to make topical creams to relieve neuropathic pain and tingling in hands and feet

Cannabis compounds have also been shown to reduce intra-ocular pressure (the fluid pressure within the eye) considerably in people with glaucoma – a type of eye disease that is caused by conditions that severely restrict blood flow to the eye, such as severe diabetic retinopathy

Insulin benefits

THCV and CBD have been shown to improve metabolism and blood glucose in human and animal models of diabetes.

A 2016 study found that THCV and CBD decreased blood glucose levels and increased insulin production in people with type 2 diabetes, indicating a “new therapeutic agent for glycemic control”. [356]

Previously, tests in mice have shown the compounds boosted metabolism, leading to lower levels of cholesterol in the blood and fat in the liver.

UK-based company GW Pharmaceuticals is currently in the process of developing a cannabis spray called Sativex, a prescription medication used to treat muscle spasms in multiple sclerosis. GW is aiming to utilise the CBD and THCV compounds in the product to help with blood sugar regulation in people with type 2 diabetes.

Meanwhile, a separate 2017 study found that cannabis use was linked with lower insulin resistance in a cohort of people with and without diabetes. [357]

Treatment for inflammation

CBD has long been known to possess anti-inflammatory properties, and because chronic inflammation is known to play a role in the development of insulin resistance and type 2 diabetes, research is investigating its efficacy in reducing inflammation in diabetes.

A 2017 study by the Medical College of Georgia revealed that CBD treatment reduced inflammation in animal models of diabetes, concluding “the nonpsychotropic CBD is a promising candidate for anti-inflammatory and neuroprotective therapeutics”. [358]

In 2015, Israeli researchers at the Hebrew University of Jerusalem reported that the anti-inflammatory properties of CBD, could treat different illnesses such as diabetes , atherosclerosis and cardiovascular disease.

In August 2015, cannabis pills containing only CBD, and not THC, were sold legally in Europe for the first time.

Treatment for peripheral neuropathy

Peripheral neuropathy is another complication reported to be eased by cannabis.

The Medical College of Georgia Study in 2017 also revealed that CBD treatment reduced the severity of diabetic retinopathy in diabetic animal models.

Another study in 2015 saw University of California researchers gave 16 patients with painful diabetic peripheral neuropathy either placebo, or single doses of cannabis, which varied in dose strength.

Tests were first performed on baseline spontaneous pain, evoked pain and cognitive function. The higher the content of THC participants inhaled, the less pain they felt

Treatment for obesity

Furthermore, GW Pharmaceuticals research has revealed that cannabis could be used to treat obesity-related diseases such as type 2 diabetes by increasing the amount of energy the body burns

In December 2014, cannabis was linked to a lower likelihood of obesity, lower BMI and reduced risk of type 2 diabetes in an Inuit population.

Cannabis drug class

Laws regarding the production, possession, use and sale of cannabis came into effect in the early 20th century.

But despite being illegal in most countries, including the UK, its use as a recreational drug is still very common.

In fact it is the most used illicit drug in the world, according to the United Nations, with approximately 22.5 million adults across the globe estimated to use marijuana on a daily basis.

Legal status

In the UK, cannabis is categorized as a Class B drug under the UK Misuse of Drugs Act.

Individuals caught in possession of marijuana are therefore given more lenient punishment – often confiscation and a ‘cannabis warning’ for small amounts.

Effects of cannabis

Cannabis causes a number of noticeable but mild (in comparison with other recreational drugs) physical and mental effects. These include:

  • Increased pulse rate
  • Dry mouth
  • Increased appetite
  • Bloodshot eyes
  • Light-headiness
  • Occasional dizzy spells
  • Problems with memory, concentration, perception and coordinated movement

Pro-cannabis groups and campaigners often highlight its pain relief benefits and stress the fact that not one cannabis-related death has ever been recorded.

Treatment for peripheral neuropathy

Another study in 2015 saw University of California researchers gave 16 patients with painful diabetic peripheral neuropathy either placebo, or single doses of cannabis, which varied in dose strength.

Tests were first performed on baseline spontaneous pain, evoked pain and cognitive function. The higher the content of THC participants inhaled, the less pain they felt

Negative effects of cannabis

Studies that have investigated this subject suggest that cannabis can have a number of effects on blood glucose control, depending on dosage. These include:

  • Memory and concentration-related problems which may affect glycemic control.
  • Raised appetite, or ‘munchies’ – a craving for sweet/fatty food, which can subsequently lead to hyperglycemia (abnormally high blood sugar levels)
  • Impaired glucose tolerance and hyperglycemia when heavily used.

Experts from Diabetes New Zealand, a national non-profit organization, also claim that cannabis indirectly affects blood glucose levels due to the drugs’ effect on the brain, which they say can lead to users not recognizing symptoms of hypoglycemia (low blood sugar) or confusing such symptoms with the effects of the drug.

People who use Low Carb Program have achieved weight loss, improved HbA1c, reduced medications and type 2 diabetes remission.

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Used in the NHS.

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