Oct 5, 2016 9:15 AM

Study Review: Marijuana and Diabetes

A day in the life of a diabetes patient is an exercise in micromanagement: to measure blood sugar and blood pressure, to make an insulin injection, to take medicines, to keep to a meal plan. Millions of people worldwide do it several times a day throughout their whole life. Thankfully, scientists are working hard on being able to help diabetes patients. And it looks like research on marijuana and diabetes treatment go hand in hand.

In order to realize the scale of the threat, here is a bit of statistics. The World Health Organization estimated that diabetes resulted in 1.5 million deaths in 2012, making the condition the eighth biggest cause of death after cancers and heart diseases. Furthermore, nearly 2.2 million more deaths were caused by high blood sugar and the increased risks of cardiovascular diseases. In fact, the figures are much more frightening: the total amount includes mortality cases attributed to diabetes both directly and indirectly, including the number of premature deaths and other fatal consequences of diabetes.

What Is Diabetes?

Diabetes is the term for a group of related metabolic conditions characterized by prolonged high blood glucose levels. The disease is associated with high levels of high-density lipoprotein cholesterol (HDL-C). The disease comes in two forms—type 1 and type 2—but type 2 accounts for about 95 percent of cases.

Normally, the pancreas releases insulin to help the body store and use the fat and sugar from the food. When either the pancreas does not produce enough insulin or the body does not respond appropriately to insulin, that leads to high levels of sugar circulating in the blood.

Symptoms of diabetes include weight gain/loss and increased hunger, thirst, and urination. Some patients can also experience headaches, fatigue, itchy skin, impotence, slow healing of cuts, and blurry vision.

The primary causes of diabetes are excessive body weight, lifestyle factors, and genetics. High blood pressure, heart and blood vessel diseases, and stress also contribute to the disease development. Most patients with diabetes are 45 years old or older, though children and young adults are also at risk.

Diabetes doubles the risk of cardiovascular and macrovascular diseases. Due to the damage in small blood vessels, the eyes, nerves, and kidneys suffer first. Damage to the eyes called diabetic retinopathy can result in blindness. Diabetic nephropathy (damage to the kidneys) may result in a chronic kidney disease, sometimes requiring dialysis or kidney transplant.

Drug Treatments for Diabetes

The primary way of diabetes blood sugar control implies meal planning, weight loss, and sports. However, unlike patients with type 1 diabetes who may only be treated with insulin or synthetic insulin analogs, it is often not enough for type 2 diabetes patients, so doctors prescribe oral medications and insulin to help lower blood sugar levels.

There are a number of different types of anti-diabetic drugs that work in different ways. Some of them, like metformin, are used orally, others, such as exenatide or albiglutide—by injection.

Metformin is the most commonly recommended first-line treatment for type 2 diabetes. Its ultimate goal is to lower the blood sugar level by decreasing the liver’s production of glucose. Canagliflozin, also known as Invokana, is a medication of the SGLT-2 inhibitor class. These inhibitors reduce excess glucose in the body through urination. Drugs of the DPP-4 class like Januvia and Janumet stimulate the pancreas to produce insulin in response to food. There are also medications that decrease the absorption of sugar from the intestines or make the body more sensitive to insulin.

Like any type of drugs, anti-diabetic pills can have a number of side effects: from relatively insignificant like diarrhea and vomiting to severe like pancreatitis, pancreatic cancer, and ketoacidosis.

Marijuana May Prevent Diabetes

A 2012 study at the University of California showed that marijuana users had a lower risk of being diagnosed with the type 2 diabetes than people who did not consume the drug. According to researchers, all participants were aged 20 to 59 and had a similar family history of diabetes.

In 2013, the American Journal of Medicine published the results of a five-year study on the impact of cannabis use on glucose, insulin, and insulin resistance among American adults. Scientists found that marijuana use was associated with sixteen percent lower fasting insulin levels, seventeen percent lower levels of insulin resistance, and higher levels of HDL-C. The findings let the researchers conclude there is a significant association between medical marijuana use and lower body mass index and lower prevalence of obesity.

The study also included the analysis of the data that excluded individuals diagnosed with diabetes. Current cannabis users were found to exhibit reduced fasting insulin and insulin resistance levels, so the researchers concluded that marijuana might help prevent the occurrence of the disease as well as manage its symptoms.

The most important finding of this study was that current marijuana users appeared to have better carbohydrate metabolism than non-users. Their fasting insulin levels were lower, so they were less resistant to the insulin produced by their body to keep a normal level of blood sugar.

Italian researchers conducting a study on cannabinoids in metabolic disorders with a focus on diabetes reported that CB1 antagonists could be used for the treatment of obesity, dyslipidemia, and type 2 diabetes. It was explained by the fact that CB1 receptors would not only facilitate energy intake as previously believed but also enhance energy storage into the adipose tissue and reduce energy expenditure by influencing both glucose and lipid metabolism. The study also showed that cannabidiol, also known as CBD, could be employed to retard beta-cell damage in type 1 diabetes.

Does Marijuana Help Diabetes?

Diabetes increases the risk for many serious health problems, which can eventually be disabling or even fatal. Observational and preclinical studies indicate that cannabis may modify disease progression and provide symptomatic relief.

Over a decade ago, the American Alliance for Medical Cannabis published a long list of the drug’s benefits on their website, which included balancing blood sugar and blood pressure, reducing neuropathic inflammation and pain, and relieving from the common “restless leg syndrome.”

Israeli scientists at the Hebrew University of Jerusalem have taken interest in the issue. In 2015, they conducted a study on rats with infarcts due to a failure of blood supply. The rats who were administered CBD showed a thirty-percent reduction of the damaged area. The findings suggested that the therapeutic effects of CBD could be modified to fit different receptors, thus making CBD a good option for treating diabetes, atherosclerosis, and cardiovascular diseases.

As Mark Rosenfeld, the CEO of a collaborating Israeli company, believes, unlike other existing anti-diabetic medication including insulin, cannabidiol may actually suppress, reverse, and perhaps even cure diabetes.

Other marijuana benefits include reducing the feelings of pain, anxiety, depression, paranoia, treating eye damage, sleep problems, and skin conditions. In mice models, marijuana has demonstrated the ability to regulate vascular inflammation, atherosclerosis, and oxidative stress, thus giving researchers a reason to suggest that cannabis-based medications might be useful in the treatment of these diabetes consequences.

For a long time, many scientists have been considering marijuana as a controversial medicine for the treatment of severe conditions like diabetes, cancers, or HIV, pointing to the lack of evidence. Fortunately, in the light of drug legalization across the United States, marijuana now attracts attention of more and more researchers worldwide, and each of their findings often leads to even greater scientific discoveries. Following up on these findings could yield new insights into how to tackle one of the biggest public health issues.

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