Marijuana and Diabetes – An In-depth Look
With marijuana legal for medical use in many American states, we take an in-depth look at marijuana and diabetes, and how it can help.
Diabetes is a chronic disease characterized by the inability to properly produce or utilize insulin. If left untreated, this disease can have severe complications and may eventually be fatal.
In 2009, there was an estimated number of 246 million people affected worldwide. In the USA alone, it is predicted that 48.3 million people will be affected by 2050. This is an astonishing number considering that in 2012 the number was estimated at 29.1 million with an average of 1.7 million new cases per year.
Insulin is a hormone involved in the regulation of blood glucose levels. After a meal, when sugar levels are high, Beta cells in the pancreas release insulin into the bloodstream. Insulin signals to the cells of the body to either store these sugars for later or to utilize them for energy. During exercise, when the blood glucose levels fall, the opposite scenario can be observed. Insulin levels drop, and stored sugars can be released from the cells and utilized for energy.
Type 1 Diabetes
This type of diabetes is associated with lack of insulin production as a result of auto-immunity. The Beta cells of the pancreas are mistakenly targeted by the immune system and killed. Insulin production becomes very low or non-existent, thus causing sugars to build up in the system. This type of diabetes is most commonly developed in childhood or adolescence, but in rare cases can also develop in adults.
Type 1 diabetes requires a lifelong insulin therapy and can be aided by proper diet.
Type 2 Diabetes
This type of diabetes can be caused by one of two factors. Either the Beta cells of the pancreas do not make enough insulin to properly store excess sugars, or the cells of the body are just insensitive to insulin. In both cases, there is a buildup of sugars in the blood stream, but none can be utilized by the cells for energy.
Type 2 diabetes is the most common form of the disease and tends to get worse with time. A controlled diet, proper exercise, and medication in the form of pills or insulin is the optimal treatment.
The symptoms associated with both types of diabetes range from mild to severe:
- Frequent urination
- Frequent hunger
- Frequent thirst
- Vision impairment
- Slow healing bruises and wounds
- Weight loss associated with Type 1
- Numbness in hands and feet, associated with Type 2
If left untreated or diagnosed too late, these symptoms can develop into serious complications:
- Skin disorders and infection
- Diabetic retinopathy which can result in cataracts and glaucoma
- Neuropathy caused by nerve damage
- Cardiovascular complications
These are the main ones amongst many others. The complications with diabetes are endless and an early diagnosis is crucial. Living with diabetes comes with a strict lifestyle and requires discipline. Currently, there is nothing on the market that could possibly reverse the damage, especially on the neural level.
Is there potential in marijuana?
Marijuana is currently legal for medical use in 24 Amerian states and its use keeps increasing worldwide. More and more evidence is surfacing about the potential medicinal properties of the plant in healing a multitude of diseases.
While we know the potential of marijuana in treating nervous disorders, little research is available on the relationship between marijuana and the metabolic processes of the body. When it comes to marijuana and diabetes, the opinions are biased but the early research looks promising.
Due to the complexity of the condition and our current lack of understanding, in depth research on marijuana and diabetes in humans is still too risky.
Animal studies, on the other hand, have opened a whole new gateway for our understanding. These studies have touched on the effects of marijuana on the prevalence of diabetes, its potential roles in diabetes-induce neuropathy, as well as its implication in cardiovascular complications.
Cannabis and Lower Diabetes Incidence
Marijuana use is very well known for the unstoppable ‘Munchies’ it induces, thus why it is so appealing to chemo patients. One would think that an increased caloric intake would result in a larger BMI.
Surprisingly, this doesn’t seem to apply to marijuana users and this is exactly where we do not yet understand the implications of marijuana in metabolic functions.
In an effort to determine if there could be a positive correlation between marijuana and diabetes, one study examined the effects of marijuana use on glucose and insulin levels.
579 participants out of the 4657 were current marijuana users and showed a lower prevalence of diabetes than non-users. Current users showed 16 % lower levels of fasting insulin as well as 17 % lower insulin resistance, both with a confidence interval of 95%.
Marijuana users in this study were also found to have lower waist circumference than non-users and increased levels of high-density lipoprotein cholesterol (HDL-C), commonly called ‘good cholesterol’.
Marijuana and diabetes can be better studied in mice models mainly because the action of cannabis derivatives can directly be examined. The natural derivatives of the plant seem a lot more promising than the casual smoking.
This was the aim of a study conducted on diabetic mice which examined the effects of cannabidiol (CBD), a non-psychoactive component of marijuana, on the incidence of the disease.
The researchers demonstrated the potential of (CBD) to reduce the occurrence and delay the onset of Type 1 diabetes. It was found that CBD shows anti-autoimmune properties which needed further examination.
While some non-specific immunosuppressive drugs have shown to be successful in preventing diabetes, they are not an ideal alternative. Suppressing the immune system in a general fashion for a long period of time would present a high-risk treatment. Moreover, these drugs showed to be working only temporarily in the clinic until resistance was acquired.
The marijuana and diabetes research is a lot more promising. While CBD is also a non-specific immunosuppressant, it was found to promote a protective immune response in diabetic mice by the means of immunomodulation. Immunomodulation would allow the use of CBD in early-onset patients only long enough to deviate the destructive autoimmune response to a protective one.
Insulin forming Beta cells showed to be saved from destruction, allowing for proper metabolism to occur. Once the immune response is reversed, patients would no longer need to use the cannabis derivatives.This mechanism of action and would prevent the long-term resistance and immunosuppressive effects of continued use.
Cannabis and the Reversal of Neuropathy
One of the harshest complications of diabetes is Diabetic Neuropathy. Clinically it is defined as “the presence of symptoms and/or signs of peripheral nerve dysfunction in people with diabetes after the exclusion of other causes”, and affects 20% of the diabetic population.
Currently, several treatments are available, but none of them are sufficient in preventing neuropathy. Opioids and anticonvulsants have plateaued at a 50% efficacy in pain reduction and are associated with severe side effects.
While the association of cannabis receptors with the nervous system has been increasingly documented, some have brought their focus on marijuana and diabetes.
Two main cannabinoid receptors are responsible with pain modulation: CB1 and CB2. CB1 has been found to be more closely associated with the nervous system while CB2 can be found in the tissues of the immune system. Both synthetic and natural cannabinoids, such as CBD, have shown to be effective in treating pain associated with neuropathy.
One research focusing on marijuana and diabetes succeeded in showing such benefits in diabetic mice. First, the mice were chemically rendered diabetic by pancreatic impairment ( I know it sounds horrible) and tested for thermal and mechanical responsiveness.
After 30 days, the rats showed a significant decrease in responsiveness to stimuli due to the loss of neural sensation. eCBD, a mixture of CBD and THC, was then administered orally. Pain assessment was recorded 7 days after administration and the animals were killed in order to further examine their nerves and liver.
The correlation found between marijuana and diabetes were groundbreaking. eCBD has shown to restore the thermal pain perception in the paws of the rats and significantly increase their impaired mechanical force.
Diabetes has been documented to increase tissue damage in the liver by destroying the antioxidant scavenger system of the organism. Close examination of the eCBD treated rat livers revealed a reversal of the oxidative stress-induced damage by restoring the defense mechanism of the organism. Diabetic retinopathy, just as neuropathy, is considered to be mainly triggered by oxidative stress. Recent advancement in the study of marijuana and glaucoma may be able to shine new light on this problem.
Cannabis and Cardiovascular Complications
Another focus of the marijuana and diabetes research is to address the cardiovascular complication associated with the disease. Diabetic patients tend to show symptoms of defective clot dissolution and thrombosis leading to macrovascular disease.
Insulin resistance has been found to disturb coagulation and platelet aggregation as well as to increase a series of coagulants in the blood, such as thrombin. Such impairment of the procoagulant state often leads to hypertension and dangerous blood clots.
In order to examine the effects of cannabis extracts (THC, CBD, CBN) on blood coagulation, one study used obese rat models.
Obese rats were found to have a 1.7 fold lower clotting time than lean rats in the laboratory. Both lean and obese rats were injected with cannabis extract for 28 days, after which blood was drawn and compared to the initial sample.
They found that CBD alone did not have any effects on thrombin activity, but that THC in combination with CBN had inhibitory effects. In both lean and obese rats, clotting time was 1.5 and 2 folds greater, respectively, than initial measurements.
This finding is another important milestone in the study of marijuana and diabetes.
While the study of marijuana and diabetes is still in the early phases, the animal research looks extremely promising. Cannabis has been used in South African indigenous medicine as a therapeutic agent for diabetes, bronchitis and pain.
Its therapeutic effects are being re-discovered in more scientific depth. Marijuana has recently shown to have important implications in treating severe neural disorders such as multiple sclerosis and epilepsy.
It then comes as no surprise that cannabinoids can also be effective in treating diabetic neuropathy. While the metabolic implications are less understood, the decreased incidence on diabetes associated with marijuana therapy is a doorway to new possibilities.
It seems that this miracle plant can cover large grounds in medical advancement and we must encourage this exponential bloom.
Do you have anyone in your surroundings currently suffering from diabetes? What are their current options for treatment? How do they feel about marijuana and diabetes?