More than a decade ago, we publish a short article here on Diabetes Mine about how marijuana (yes: pot, grass, weed, ganja) can be use to treat diabetes, and people flock here to learn more. Now that it’s (mostly) legal, we’ve take a broad look at the topic and a growing body of research (okay, much of it in animals) showing how cannabis can have a number of positive effects on diabetes. Find Weed in DC.
Marijuana for diabetes
One of the first major reports ever publish by the American Association for Medical Cannabis (AAMC) states that cannabis is believe to have the following benefits for people with diabetes:
- stabilizing blood sugar (confirm by “a large amount of anecdotal evidence of concentration among diabetics”)
- anti-inflammatory action that can help suppress some of the arterial inflammation common in diabetes
- “neuroprotective” effects that help prevent nerve inflammation and reduce neuropathy pain by activating receptors in the body and brain
- “Antispasmodic agents” help relieve muscle cramps and pain in gastrointestinal (GI) disorders
- acts as a “vasodilator” to keep blood vessels open and improve circulation
- helps lower blood pressure over time, which is vital for diabetics
- Replacing butter and hemp oil in foods ‘benefits heart and artery health in general’
- can also be use to make topical creams to relieve neuropathic pain and burning in hands and feet
- helps alleviate diabetic ‘restless legs syndrome’ (RLS) so the patient can sleep better: “Patients are advise to use a vaporizer or smoke cannabis to help them sleep”
The evidence for all of this still exists and in fact has been document and update over the past decade.
Research on diabetes and cannabis
While there is some conflicting evidence about marijuana’s role in delaying the risk of developing type 2 diabetes, research shows that it is actually helpful for those already diagnose with type 1 or 2, and especially for those suffering from complications.
A landmark study publish in the American Journal of Medicine in 2013 conclude:
- Cannabis compounds can help control blood sugar
- Marijuana users are less obese and have a lower body mass index (BMI) – despite appearing to consume more calories
- Pot smokers also had higher levels of “good cholesterol” and less occupation
“The most important finding was that current marijuana users seem to have better carbohydrate metabolism than non-users. Their post-fasting insulin levels were lower and they appear less resistant to the insulin their bodies produce to maintain normal sugar levels. in the blood.” say Murray Mittleman, associate professor of medicine at Harvard Medical School and chief researcher for TIME magazine.
In 2014
A “summary of promising epidemiologic evidence” on marijuana in the treatment of diabetes publish in the journal Natural Medicine also conclude that in thousands of people, past and current marijuana use was associate with lower levels of post-fasting insulin, glucose in blood, insulin resistance, BMI and waist circumference.
And in 2015, Israeli researchers from the Hebrew University of Jerusalem published a study showing that the anti-inflammatory properties of cannabidiol (CBD), a compound find in hemp, can be use effectively to treat various diseases, including type 2 diabetes. There is also compelling scientific evidence that cannabis can help treat complications of diabetes, such as eye disease. Cannabis significantly lowers intraocular pressure (fluid pressure in the eye) in people with glaucoma, which is cause by conditions that severely restrict blood flow to the eye, such as diabetic retinopathy. Pretty powerful stuff!
Why medical marijuana?
When most illegal substances are frown upon, why talk so much about marijuana as a medicine, what can actually be good for you?
The band-aid doesn’t seem to be something call the endogenous cannabinoid system, name after the plant that led to the discovery, which is “perhaps the most important physiological system involve in creating and maintaining human health,” NORML. The National Marijuana Law Reform Organization, base in Washington.
They explain: “Endocannabinoids and their receptors are find in the body: in the brain, organs, connective tissue, glands and immune cells. In each tissue, the cannabinoid system performs different tasks, but the goal is always the same: homeostasis, maintaining a stable internal environment despite fluctuations in the external environment… Cannabinoids promote homeostasis at all levels of biological life, from the sub-cellular, in the organization and perhaps in the community and beyond. “
As such, NORML and other marijuana advocates and supporters “believe that small, regular doses of cannabis can act as a stimulant to our central physiological healing system.”
How Can Marijuana Help Diabetes?
So let’s say you use marijuana or want to try it. What effect would it have on your diabetes? Many people with disabilities report that with regular use, they see lower blood sugar levels and lower A1c scores over time. Existing scientific evidence shows that marijuana has an effect on improving insulin resistance – it is helpful for type 2 diabetes, but mostly not for type 1. There is little more than anecdotal evidence.
However, as mention, there is a lot of evidence that marijuana is effective in treating eye disorders, chronic pain, sleep disorders, and a number of other conditions often associate with diabetes. So, if you are living with one or more complications of diabetes, marijuana can very easily ease your pain or slow the progression of the disorder you are living with. The mental health field is great for marijuana because it has been show to effectively treat everything from clinical depression to post-traumatic stress disorder.
Why is this?
One answer may come from a study publish in February 2015 showing that using marijuana in animals help restore levels of endocannabinoids in the brain—which affect emotions and behavior and are associate with reduce feelings of pain and anxiety and increase emotions wellness.
Of course, some people with depression will not do well with marijuana, because it can also increase feelings of anxiety and paranoia in some people. The biggest risk of marijuana use in diabetes is probably hypoglycemia. there is a great fear that the impaired glucose level will decrease, the patient does not notice this until he is in dangerous territory.
In other words: marijuana can help lower blood glucose levels, make you feel better, more relax and pain-free, but you also need to be careful. It appears that the health establishment’s consensus is only about that.” more research is need .”
Is it legal?
Well it depends. The recreational use of marijuana remains a crime everywhere in the United States, with one exception in Alaska, Colorado, Oregon, Washington and the District of Columbia (DC). However, the medical use of marijuana is quickly being adopt. As of this writing they are now legal in 23 states and DC. The American Medical Cannabis Association’s website offers an excellent overview of what certain laws are in each state .
For example
In the state of California, with medical approval, it is now legal to possess up to 8 ounces of dry marijuana and 6 mature or 12 immature marijuana plants – wow! So how do you get a medical marijuana card that gives you legal access to medicinal cannabis? Generally there are three basic requirements :
- proof of residence in the state or territory in which it is legal
- acceptable “serious health condition” – definitions vary from state to state (for example, California adheres to the Americans with Disabilities Act of 1990, which requires any chronic condition that either severely limits a person’s ability to perform one or more important lifestyles). “and specifically lists diabetes. Elsewhere, accepted conditions include complications of diabetes, such as eye disease or chronic pain neuropathy )
- approval from the doctor who wants to prescribe it for you
We know anecdotally that in the San Francisco Bay Area, it’s pretty easy to find a doctor willing to sign papers and send you to the local dispensary to pick out your favorite Mary Jane variety. There are even now delivery services in many states where a truck picks up in front of your house, just like a pizza man.
CBD oil for diabetes
As marijuana becomes more legal and socially acceptable, so do hemp byproducts. CBD oil is particularly attracting attention as a health aide. But should you use it if you have diabetes?
What is CBD oil and how is it use?
Cannabidiol, better know as CBD Oil, is produce by extracting the substance from the hemp plant and diluting it with a “carrier” such as coconut or hemp seeds. It is attribute to the relief of symptoms of a number of diseases, including chronic pain, anxiety and depression.
The pure oil form is usually taken by placing a dropper under your tongue with a dropper and holding it there for at least 60 seconds – to allow absorption through the blood vessels under the tongue. Once 60 seconds have pass, swallow the CBD oil. How much to take It depends on the disease you want to treat, but it usually ranges between 2.5-20 mg per day.
Is CBD oil good for diabetes?
Emily Kyle, a register dietitian and cannabis holistic medicine expert in New York, tells us that like any supplement or over-the-counter drug, there are obvious problems with using CBD oil if you have type 1, type 2, or gestational diabetes. These concerns can range from the type and quality of the product use to a variety of potential side effects. The biggest concern lies in the potential for cannabinoid-drug interaction for those taking prescription drugs and insulin to manage diabetes.
Unfortunately
There is a lack of clinical studies on CBD oil’s direct effect on blood sugar, possibly due to the illegal status of marijuana, which is currently consider a schedule 1 drug in the eyes of the federal government, Kyle says.
“What we do know is that the endocannabinoid system plays an important role in how the body responds to insulin, increasing or decreasing insulin sensitivity. This is vital for those taking insulin because it could mean their blood sugar could rise or fall unexpectedly, making tight control harder to achieve,” he says.
“Anecdotally, I’ve had clients show completely different reactions to using CBD oil. One client tell me that she had dramatically lower her blood sugar levels within minutes, which is potentially very dangerous. Other customers notice no effect on blood sugar at all. This is attribute to the uniqueness of each individual’s endocannabinoid system and their personal endocannabinoid tone. “
Read also: Guide – How to Find Weed?
Diabetes and Marijuana: Doctors Say…
ISSUES IN THE FIELD
Shara Bialo, an endocrinologist and type 1 patient in Rhode Island, tells us that as a pediatric endocrinologist, she mostly gets questions from the teenagers she treats:
Everyone asks the same question: “I’ve hear that marijuana can be good for lowering blood sugar. Is it true?” I have to approach this matter carefully, so I start by reminding them that marijuana is not legal where I practice. But I also explain that it has been show to improve insulin resistance, which means it may be more helpful in type 2 diabetes.
Also, no studies of this kind have been conduct in minors. Then I ask other problems – that overeating can cause “cravings” (and usually not for low carb foods!) and this unclear state of mind can lead to inaccurate insulin dose calculations or miss doses. I then conclude with the proposition that there is not enough evidence to show that marijuana is more safe than harmful, at least when it comes to diabetes. Most people are fine with that answer, if not a little disappoint.).
Caution
A certified diabetes educator (CDE), author, and type 1 patient himself, Gary Scheiner of Pennsylvania says he offers his patients these words of caution:
The latest statistics show that nearly 30% of people with diabetes between the ages of 16 and 30 have at least tried marijuana, so this is a common concern. Although not closely relate to tobacco cancer, it can have harmful effects on cognitive functions and can negatively affect diabetes control:
- Impairs judgment (for example, leads to incorrect insulin dose)
- Increases appetite and leads to overeating
- Contamination (unregulated marijuana) with impurities such as lead may contribute to early kidney disease
OPEN COMMUNICATION
2015 Diabetes Educator of the Year Susan Weiner, who is also known for her books and columns on diabetes care, tells us that most healthcare professionals insist on not even discussing this topic, but in reality should not:
Most health care providers are “skeptical” and “wary” and probably a little nervous about recommending marijuana use to people with diabetes. While there are some encouraging studies on marijuana’s benefits for insulin levels, weight management, lowering blood pressure (and a host of other potential benefits), the research is conflicting. More accurate studies and evidence-based research are need before cannabis can be recommend for most people with diabetes. We also need to determine whether additional conditions, such as heart disease, would preclude the use of marijuana as part of a diabetes treatment plan. With these problems, determining the appropriate dose is problematic.
Over the years
Very few of my patients have speak to me about their marijuana use as it relates to their diabetes care. However, many have tell me that they use marijuana recreationally… I think it is essential to have a very open dialogue with my patients about anything relate to health and diabetes. We really worry if my patient feels uncomfortable discussing this or any other topic with their endocrinologist or primary care physician. I always tell my patients that they are the leaders of their own health care team, so their concerns and suggestions are key.
If they ignore the issue, they do the patient a disservice if they want to talk about something. To approach sensitive topics (for example: marijuana use, sexual dysfunction, or health literacy), I ask open-end questions, use motivational interviewing methods, and actively listen to what the patient has to say. Although we providers often want to educate and impart as much knowledge as possible to our patients, it is more important to listen to what is important to them.
USE RESPONSIBLY
Dr. Korey Hood, professor of pediatrics, psychiatry and behavioral science at Stanford University School of Medicine, explains:
Although I belong to the Medical Establishment as a PhD Clinical Researcher and license psychologist, I do not prescribe or administer medical care. But I am very involve in the multidisciplinary care of people with diabetes as well as prevention and treatment research. I note that the general attitude of diabetes care providers regarding the use of marijuana in people with diabetes is that they should not use it recreationally.
In my experience
The group of patients most likely to wonder about this are teenagers and young adults. My approach is to follow these guidelines: a) It is generally best to start a discussion about substance use with teenagers (either define by a chronological age of around 12 or by developmental level if they are more mature than most other 11 years old). , b) it’s better to provide prevention-orient information and education than a “just say no” approach that doesn’t work, and c) always review the legal guidelines, depending on the state I work in (currently California). I strongly support trying to talk early and often and provide factual information.
We always try to have open and honest conversations about marijuana (and other substances, especially alcohol) use. I usually look at the following, often in this order:
- It is important to know the laws of your country. Most states have not legalized recreational use, while some states have legalize medical marijuana. Decriminalization should not be confuse with legalization. If I’m talking to young people under 18, I usually emphasize that more than I would with older adults.
- But if you’re going to use it, it’s best to do it as responsibly as possible. “Responsible” use means moderation and trying to avoid use until the brain is fully develop (around age 25). I always mention that there are studies showing that even recreational use can have negative effects on brain function and mood. These effects are worse for everyday users. There is also data, mostly in studies in men, that negative effects on fertility, I try to review what we know (and what we don’t know) so that any use is include with eyes wide open.
From a diabetes perspective
- I usually focus on the indirect effects of marijuana use. While I don’t know of any lab data on direct effects of THC (the main psychoactive ingredient in cannabis) on blood glucose levels, I focus on the indirect effects of taking the “munchies” and usually don’t make good decisions about insulin or other medications after using marijuana . A typical scenario I have been told is that there is overeating and the sugar ends up high. Occasionally there is an excessive bolus, but this appears to be less common.
- I also talk about ways to ingest marijuana and that there are more risks associated with smoking, as opposed to eating, compared to using vaporizers. Smoking tobacco/cigarettes is one of the areas I advocate for people with diabetes (and those without) that I would never do. Smoking marijuana can also have negative effects. I do not recommend the way you can do this, but discourage smoking in any form.
- Finally, I always say that “responsible” use means not driving after any use, having someone around you who knows you have diabetes and isn’t affected, and making sure someone around you knows how to deal with extreme falls or at most when needed.
