Medical Marijuana and Diabetes

Treatment with Cannabis

The medical literature has very few citations in regard to any direct effect of cannabis on blood sugar levels. These citations are sometimes contradictory. Despite the lack of research, a large body of anecdotal evidence is building amongst diabetic sufferers that medical cannabis may help stabilize blood sugar. One suggested method that may be responsible is the reduction in catecholamines and/or stress related hormones (glucocorticoids) that is caused by cannabis.

Many cannabinoids act primarily to inhibit prostaglandins and COX-2, while providing powerful anti-oxidant properties to salvage free radicals, and inhibit macrophage and TNF. All of this means that cannabis is an excellent anti-inflammatory that lacks the side effects of steroids (which diabetics have to avoid), the NSAIDS, and the COX-2 inhibitors like Vioxx. This anti-inflammatory action may help quell some of the arterial inflammation common in diabetes.

Cannabis is also neuroprotective. It is believed that much of neuropathy comes from the inflammation of nerves caused by glycoproteins in the blood that deposit in peripheral tissues and trigger an immune response. Cannabis helps protect the nerve covering (myelin sheath) from inflammatory attack. Cannabis also lessens the pain of neuropathy by activating receptors in the body and brain. Some components of cannabis (perhaps cannibidiol) act as anti-spasmodic agents similar to the far more toxic anti-convulsants like Neurontin. This action of cannabis helps relieve diabetic muscle cramps and GI upset.

Two other major actions of cannabis can benefit the diabetic. The first is helping to keep blood vessels open and improving circulation. Cannabis is a vasodilator and works well to improve blood flow. The second action is how cannabis can reduce blood pressure over time. While cannabis is not generally thought to be an anti-hypertensive and is no replacement for ACE inhibitors, it does contribute to lower blood pressure which is vital in diabetes management.

Finally, cannabis used in food products not only provides long lasting blood levels of key cannabinoids but, in addition, cannabis butter and oil substitute triple bonded fatty acids for the saturated fats normally contained in these essential cooking products. This substitution will benefit cardiac and arterial health in general.

Most diabetics learn very early that maintenance of good blood sugar is most easily achieved when patients or their caregivers cook as opposed to eating fast food or prepared foods. Cooking not only provides superior nutrition necessary to treat diabetes but also is a form of physical therapy for diabetic hands that suffer from neuropathy. Of course, diabetics should take caution with any flames or hot objects.

Cannabis may also be used to make topical creams (mixed with aloe vera and/or emu oil) that can be applied directly to hands and feet affected by neuropathic pain and tingling.

Night time can be particularly difficult for diabetics. A syndrome known as "restless leg syndrome" (RLS) is common. Cannabis helps still RLS which is otherwise treated with quinine and/or muscle relaxants like Flexaril. For night time it is recommended that patients use a vaporizer or smoked cannabis to aid in falling asleep. If night time hypoglycemia is a problem then a cannabis cookie can be very helpful. Cannabis cookies are great treatment so long as portion control is exercised.

Medical Marijuana and Diabetes Mellitus

Diabetes mellitus is a group of autoimmune diseases characterized by defects in insulin secretion resulting in hyperglycemia (an abnormally high concentration of glucose in the blood). There are two primary types of diabetes. Individuals diagnosed with type 1 diabetes (also known as juvenile diabetes) are incapable of producing pancreatic insulin and must rely on insulin medication for survival. Individuals diagnosed with type 2 diabetes (also known as adult onset diabetes) produce inadequate amounts of insulin. Type 2 diabetes is a less serious condition that typically is controlled by diet. Over time, diabetes can lead to blindness, kidney failure, nerve damage, hardening of the arteries, and death. The disease is the third leading cause of death in the United States after heart disease and cancer.

A search of the scientific literature reveals no clinical investigations of cannabis for the treatment of diabetes, but does identify a small number of preclinical studies indicating that cannabinoids may modify the disease’s progression and provide symptomatic relief to those suffering from it.[1-2] Most recently, a study published in the journal Autoimmunity reported that injections of 5 mg per day of the non-psychoactive cannabinoid CBD significantly reduced the incidence of diabetes in mice. Investigators reported that 86% of untreated control mice in the study developed diabetes. By contrast, only 30% of CBD-treated mice developed the disease. In a separate experiment, investigators reported that control mice all developed diabetes at a median of 17 weeks (range 15-20 weeks), while a majority (60 percent) of CBD-treated mice remained diabetes-free at 26 weeks.

Investigators also found that CBD significantly lowered plasma levels of the pro-inflammatory cytokines (proteins) INF-gamma and TNF-alpha and significantly reduced the severity of insulitis (an infiltration of white blood cells resulting in swelling) compared to non-treated controls. “Our results indicate that CBD can inhibit and delay destructive insulitis and inflammatory … cytokine production in … mice resulting in decreased incidence of diabetes,” authors concluded.

Other preclinical trials have demonstrated cannabinoids to possess additional beneficial effects in animal models of diabetes. Writing in the March 2006 issue of the American Journal of Pathology, researchers at the Medical College of Virginia reported that rats treated with CBD for periods of one to four weeks experienced significant protection from diabetic retinopathy. This condition, which is characterized by retinal oxygen deprivation and a breakdown of the blood-retinal barrier, is the leading cause of blindness in working-age adults.

Cannabinoids have also been shown to alleviate neuropathic pain associated with the disease. A pair of studies published in the journal Neuroscience Letters in 2004 reported that mice administered a cannabis receptor agonist experienced a reduction in diabetic-related tactile allodynia (pain resulting from non-injurious stimulus to the skin) compared to non-treated controls. The findings suggest that “cannabinoids have a potential beneficial effect on experimental diabetic neuropathic pain.”

Finally, a 2001 trial demonstrated that delta-9-THC could moderate an animal model of the disease by reducing artificially-elevated glucose levels and insulitis in mice compared to non-treated controls. With the incidence of diabetes steadily increasing in both the adult and juvenile population, it would appear that further cannabinoid research is warranted in the treatment of these diseases.