Can Medical Marijuana Treat Diabetes Mellitus Type 2 in Adults?

Treating diabetes with medical marijuana

The progression of diabetes can be slowed with medical marijuana according to research. Additionally, multiple complications derived from having diabetes mellitus can be successfully treated with medical marijuana. To begin medical marijuana treatment for diabetes, contact your local Florida marijuana doctor. Find out if you pre-qualify for a medical marijuana recommendation in 5 minutes or less by completing our online eligibility survey.

The pandemic of Diabetes Mellitus (DM)

Diabetes is one of the most prevalent diseases today. Over 30 million people in the United States now have DM, with an additional 84 million being pre-diabetic. [1] Statistics state that its incidence has about doubled within the last 40 years. Two out of five Americans are expected to develop diabetes within their lifetime. It is a problem both in the United States and worldwide. Diabetes is becoming a pandemic, in that around 8.5% of adults worldwide now have diabetes. [2] Diabetes not only contributes to early deaths, but it is also a major cause of kidney failure, heart attacks, stroke, blindness, and limb amputation. This is just the beginning of the possible complications with diabetes!

Can medical marijuana lower incidence of diabetes (DM)?

• A study published in the American Journal of Medicine in 2013 found that current marijuana users had 16 % lower fasting insulin levels. Their waist circumference was also smaller. [1] Other studies have shown similar results.
• Increased fasting insulin is a key marker for the development of pre-diabetes and diabetes. If medical marijuana can lower insulin levels, then the likelihood of it developing from pre-diabetes to diabetes is lowered. Unfortunately, most physicians do not routinely test for fasting insulin.
• Experimental evidence and clinical trials show that the endocannabinoid system (ECS) plays a key role in the development of diabetes and its complications. The effects can be both positive and negative. On the positive note, both CBD and THCV have tremendous therapeutic potential. They decrease inflammation and oxidative stress. (THC-V is another cannabinoid found in very small amounts in medical marijuana.) [3] [4]
• Compounds that inhibit the CB1 receptor or stimulate the CB2 receptors are beneficial to diabetes and its complications. (Remember that a receptor is a molecule on the cell membrane that responds specifically to another substance.)
• However, on the negative note, CB1 receptor activation can increase harmful reactive compounds, thereby increasing inflammation and diabetic complications. [3]

The story of glucose, insulin, and insulin resistance

• What causes diabetic complications? Normally, with an increase of blood sugar (called glucose), there is a release of insulin from the beta cells of the pancreas. The insulin attaches to the receptor outside of the cell. This allows the sugar molecule to enter the cell.
• However, with type 2 DM, the level of sugar (glucose) in the blood rises abnormally high. It does not clear quickly from the bloodstream. One of these two scenarios may occur: Either the pancreas is producing enough insulin, but the cells are insulin resistant, so the blood sugar does not quickly lower; or the pancreas is no longer producing enough insulin, so not all of the sugar is quickly being taken into the cell. Either way, the excess sugar forms reactive compounds that harm all cells and cellular organelles that are exposed to it. This is the basis of how diabetic complications begin. [3] These reactive compounds cause inflammation and oxidative stress.

So, what are some diabetic complications?

• Disease of the heart muscle (cardiomyopathy) can occur with diabetes. What happens to the heart? The left bottom part of the heart enlarges abnormally in size. This is called left ventricular hypertrophy with diastolic dysfunction. All of this occurs secondary to dangerous reactive compounds (called ROS). You can protect your heart by taking CBD. CBD activates CB2 receptors, which works to protect against this problem. [3]
• The small blood vessels of your eyes and kidneys are damaged with high sugar and high insulin. Microvascular complications such as eye disease (retinopathy), kidney disease (nephropathy), and peripheral neuropathy often occurs with diabetes. Any damage secondary to inflammation is decreased with medical marijuana. It also helps control pain.
• Medical marijuana improves nerve (neuropathic) pain. About 60-70% of people with diabetes have some kind of nervous system damage. CB1 receptor antagonism halts progression of diabetic neuropathy and helps with the pain. CBD was able to attenuate the development of neuropathic pain. In a study using low-dose vaporized delta-9-tetrahydocannabinol, with patients who were not getting relief from conventional pain relievers, they had significant relief. This was without having much impact on daily functioning. [4]
• Diabetes also affects the larger (macro) blood vessels. Macrovascular complications occur with diabetes, such as heart attack, stroke, and peripheral arterial disease (PAD). Medical marijuana is anti-inflammatory. It is thought to quell diabetic atherosclerotic plaque that causes these macro-vascular complications.
• Diabetics often have oxidized blood fats (lipids). Oxidized blood fats (LDL) cause damage to the lining of the blood vessels. While it helps to have fat soluble antioxidants to travel attached to the LDL, medical marijuana also helps, in that it decreases endothelial activation by decreasing reactive compounds called (ROS).
• Diabetics often have high blood pressure (hypertension). Medical marijuana can open the blood vessels wider (is a vasodilator). This lowers high blood pressure. It also improves circulation.
  Often, diabetics cannot sleep well at night due to restless leg syndrome. Medical marijuana is antispasmodic, causing these spasms to dissipate.
• Obesity and DM are twin pandemics. Plasma endocannabinoids are elevated in obese patients, as well as diabetics. [5]. While CB1 is increased in obese rodents, CB2 is decreased in peripheral tissues.
• The thought is that CB2 possibly opposes the pro-obesity effects of CB1 signaling [7]. Indeed, when an experiment was done that inhibited or deleted CB2 in non-obese rats, the result was increased food intake, increased body weight and increased fatty tissue (called adipose tissue hypertrophy)[8]. Thus, recent studies discuss the possibility of CB2 (receptor) stimulation in order to reduce food intake and body weight gain without having an impact on mood [7] [8].
• Phoenix Life Sciences International (PLSI)- is researching new products to target and treat diabetes. The company is importing a new medical cannabis diabetes product into the Republic of Vanuatu. This island state has thirteen percent of its 265,000 residents suffering from diabetes. Their healthcare system is in an emergency mode, because within a ten year period, diabetes increased by 55%. Clinical trials will begin with 1000 patients. The writer of this blog has actually been to Vanuatu and concurs that changes from their historical diet and lifestyle are bearing negative results. It is hoped that medical marijuana will help stave off complications from their diabetes.[2]

Are there particular strains of medical marijuana specific to treating diabetes?

• There are certain strains that are more helpful than others for diabetic medical marijuana patients. Of particular interest is Doug’s Varin, due to its higher level of THC-V. In a study of 62 diabetic patients, THC-V was found to improve fasting insulin levels and reduce blood glucose. The strain Cannatonic has helped with diabetic pain and muscle spasms. [9]
• While findings show that medical marijuana can be helpful in treating diabetic complications, it is important that you seek out a licensed medical marijuana physician to get the most pertinent care.

References:

1. https://www.benzinga.com/markets/cannabis/18/10/12460731/the-science-on-how-cannabis-could-help-diabetes-patients
2. https://www.forbes.com/sites/andrebourque/2018/12/05/can-cannabis
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349875/
4. https://www.ncbi.nlm.nih.gov/pubmed/27573936
5. Berger, Piscitelli, Hoem, and Silvestri; Anandamide and diet: Inclusion of dietary archidonal and doxosahexaenoate leads to increased brain levels of the corresponding… Proc. Natl. Acad. Sci. USA 2001, 98, 6402-6406.
6. Ward, S.J., Rimonabant redux and strategies to improve the future outlook of CB1 receptor neutral- antagonist/inverse-agonist therapies, Obesity 2011, 19, 1325-1335.
7. Schmitz, Mangels, Haussler, and Ferreisos. Pro-inflammatory obesity in aged cannabinoid-2 receptor deficient mice. Int. J. Obes. 2016, 40, 366-379.
8. https://www.ncbi.nlm.nih.gov/pubmed/26588700
9. https://www.marijuanabreak.com/marijuana-strains-diabetes

Dr. Ross Glider

Dr. Glider is a board certified Internal Medicine Specialist.  He received his Florida Medical Marijuana Physicians Certification in 2017 and was one of the first recommending physicians with DocMJ. In addition to medical marijuana recommendations, Dr. Glider continues to practice Internal and Geriatric Medicine in private practice. Additionally, he serves as Medical Director for a home health company, supervising and educating staff, as well as supervising an advanced Registered Nurse Practitioners for a transitional care program.

Dr. Glider graduated from the College of Osteopathic Medicine & Surgery in Des Moines, IA and completed his residency at Saddlebrook General Hospital in Saddlebrook, NJ. He has received several honors and awards throughout his professional career, including a City of Des Moines Merit Award and a Chamber of Commerce Award (Port St. Lucie, FL).  Dr. Glider is an experienced and caring physician who is loved and respected by his peers and his patients.