After alcohol, marijuana (also known as cannabis) is the most commonly used drug in the world. The United Nations World Drug Report 2016 estimate there are 182.5 million users globally.
This article explores the medicinal properties of marijuana and how its use might benefit people with diabetes. It also examines the potential downsides of using marijuana for people who have diabetes and what the legal status of the drug is.
Cannabinoids found in marijuana may affect memory, mood, pain, and coordination.
Compounds in marijuana are believed to be responsible for the health benefits associated with the plant. These are called cannabinoids.
Cannabinoids interact with receptors found in the central nervous system of the body. This can affect a number of processes such as:
Of all the cannabinoids in marijuana, THC and cannabidiol (CBD) are the most commonly studied.
THC is the main psychoactive component in cannabis, producing the "high" associated with the drug. CBD is not considered psychoactive, but has a number of medicinal uses. As such, it is of interest to those considering marijuana for medical use.
Medical marijuana and synthetic drugs
The term "medical marijuana" means the use of the whole, unprocessed cannabis plant (or extracts from it) to treat certain health conditions.
It should be noted that the U.S. Food and Drug Administration (FDA) has not approved marijuana as a safe and effective drug for any condition. The FDA has, however, approved the following medications containing synthetic versions of THC:
- dronabinol (Marinol)
- nabilone (Cesamet)
Clinical trials are also being conducted on CBD-containing drugs, some of which are already approved in Europe.
Several studies have highlighted a number of benefits of marijuana use for those with diabetes.
A 2005 paper, published by the American Alliance for Medical Cannabis (AAMC), suggests that marijuana may be used by people with diabetes to:
- stabilize blood sugar levels
- lower arterial inflammation
- reduce neuropathic pain, the most common complication of diabetes
- lower blood pressure over time
- improve circulation
- relieve muscle cramps
- reduce gastrointestinal pain and cramping
This research has been built upon in more recent years, and other benefits have been associated with marijuana use, including:
Smaller waist size and less risk of obesity
A person may develop type 2 diabetes if they are overweight and studies suggest marijuana use may be associated with smaller waist size.
Being overweight or obese is one of the biggest risk factors in the development of type 2 diabetes. According to Diabetes UK, obesity may account for 80 to 85 percent of the risk of developing the condition.
Studies show that marijuana may help reduce the risk of diabetes.
For example, researchers in a 2013 study of 4657 people, including 579 current marijuana users and 1975 past users, found that marijuana use was associated with a smaller waist size. On average, regular users had waists that were 1.5 inches (3.8 cm) slimmer than people who had smoked marijuana in the past, or those who never did.
This backs up previous research, which indicates that obesity occurs less often among cannabis users than in non-users.
Increased insulin sensitivity
Being able to use insulin effectively is vital for health. However, those with type 2 diabetes are less sensitive (more resistant) to the effects of insulin in the body.
Research has shown that marijuana users may have increased insulin sensitivity. In the study of 4657 people mentioned above, it was found that the fasting insulin levels of users were 16 percent lower than former users and non-users. Their levels of insulin resistance was also 17 percent lower.
A 2015 study of people with non-insulin-treated type 2 diabetes indicates that a form of THC:
- significantly decreased fasting blood glucose
- improved the production of insulin
- raised levels of adiponectin (protein that regulates blood sugar)
Inflammation is believed to play a role in the development of type 1 and type 2 diabetes, and other chronic diseases.
Some 2015 research, suggests that the anti-inflammatory properties of CBD can treat the inflammation contributing to diabetes, and associated complications.
Protection against retinopathy
The results of some research carried out on animals suggests that 1 to 4 weeks of CBD treatment provided 'significant protection' from diabetic retinopathy.
Diabetic neuropathy is a common complication of diabetes. It is a form of nerve damage that occurs most often in the legs and feet, but also in other parts of the body. Neuropathy can be extremely painful, and even fatal in some cases.
A 2015 study on people with neuropathic foot pain suggests that inhaling cannabis can provide relief from diabetic neuropathic pain for several hours. Researchers found that the higher the dose of THC administered, the greater the pain relief.
Marijuana use for people with diabetes may have several benefits but there are also disadvantages. These include hyperglycemia (high blood sugar), hypogylcemia (low blood sugar) and number of other considerations.
High blood sugar
The main disadvantage of using cannabis for diabetes is related to an increased appetite. This is often experienced by users and is commonly known as "the munchies". This may lead people to crave and eat large amounts of carbohydrates.
This can be an issue for those with diabetes as carbohydrates cause blood sugar to rise rapidly. Severely elevated blood sugar levels may result in a medical emergency.
Low blood sugar
Abnormally low blood sugar levels can also be dangerous for those with diabetes.
Low sugar levels is caused by too much insulin and not enough glucose in the blood. Symptoms include:
- rapid heartbeat
There are some concerns that marijuana users may not notice their blood sugar levels have dropped when intoxicated. It is also a worry that they may attribute symptoms of low blood sugar to the drug use.
Other disadvantages and risks of marijuana use
Side effects of marijuana use may include an increased heart rate, dizziness, and impaired concentration.
Other potential undesirable side effects of marijuana use include:
- addiction (may occur in 9 percent of adults who use marijuana)
- increased heart rate
- interactions with prescription or over-the-counter medications
- breathing issues
- withdrawal symptoms
- delayed reaction times
- impaired concentration and memory
Topical CBD hemp oil
The AAMC advises the use of topical marijuana treatments made with aloe vera or other oils. People can apply these directly to their hands and feet to reduce the pain and tingling sensations associated with diabetic neuropathy.
A variety of CBD and hemp oils, lotions, and balms are available to buy. As they are generally made with CBD, rather than THC, these products are non-psychoactive.
In the United States, marijuana is illegal under federal law. However, as of April 2017, 28 states have passed laws to decriminalize its use for specific medical conditions. A doctor's prescription is required in these cases.
Recreational marijuana use is legal without prescription in the following eight states, plus Washington D.C.: