MEDICAL CORNER: CANNABIS & DIABETES
In the U.S., over 29.1 million people are currently diagnosed with diabetes. This is almost 10 percent of the population. Furthermore, two out of three of these people will die from the condition or the many compilations that arise from it. This has prompted researchers to look into how medical marijuana can help treat diabetes and its associated complications.
Type 1 diabetes, often termed juvenile diabetes, is a genetic disorder where the pancreas doesn't produce enough insulin -a hormone that allows the body to process the sugars from carbohydrates. Sufferers of Type 1 diabetes often take multiple injections of insulin each day. On the other hand, Type 2 diabetes [also known as adult onset diabetes) is a disorder where the body doesn't process insulin property, often signaling the pancreas to make more insulin than required. This is the most common type of diabetes.
Medical marijuana has been the focus of several studies examining potential diabetes treatment. One such study, published in the American Journal of Medicine, found that active users of marijuana had a more productive carbohydrate metabolism than people who didn't use marijuana.1 Murray Mittleman, Associate Professor of Medicine at Harvard and author of the study, said, "[Marijuana users') fasting insulin levels were lower, and they appeared to be less resistant to the insulin produced by their body to maintain a normal blood-sugar level."
The study comprised over 4,657 men and women participating in the National Health and Nutrition Examination Survey between 2005 and 2010 - 48 percent had smoked marijuana at least once and 12 percent were current cannabis smokers. The researchers controlled for other factors that might impact diabetes risk, such as gender, income, alcohol use, cigarette smoking and physical activity. Even after these adjustments, the current marijuana users showed fasting insulin levels that were 16 percent lower than those of former users or those who had never used the drug.
These findings are applicable to both types of diabetes. In Type 1 diabetes, a lower fasting level might eliminate the need for an insulin injection at that time. While injections wouldn't be completely eliminated, it could decrease the number needed per day. For those with Type 2 diabetes, being less resistant to the insulin could help control the advancing of the disease by improving the body's ability to manage sugar levels naturally.
Some of the complications that can arise from Type 1 and Type 2 diabetes are neuropathy, glaucoma, high blood pressure, and peripheral vascular disease. Medical marijuana has been studied to see its effects on each of these conditions.
Neuropathy, a nerve damage contracted from certain diseases or disorders, is found in 60 to 70 percent of all people with diabetes. More specifically, there are four types of diabetes-related neuropathy. Peripheral (located in the hands, arms, legs and feet), autonomic (which affects the nerves that control blood glucose levels, blood pressure, and the heart), focal (specific nerve damage to the head, torso, and leg], and proximal (sometimes called diabetic amyotrophy and usually centralized on one side of the body in the hips, thighs, and buttocks].
Several studies have shown vaporized cannabis to reduce pain and slow the advancing nerve damage of all four types of neuropathy. In some types, there was more than a 30 percent improvement without any significant impact on daily functioning or cognitive abilities.
Glaucoma is another complication that can arise with diabetes. The general term for glaucoma-related complications is retinopathy. People who have diabetes are 40 percent more likely to contract glaucoma than people without the disease. Glaucoma occurs when pressure builds inside the eye, eventually cutting off blood flow and damaging the optic nerve. Vision is gradually lost due to the continued pressure and nerve damage.
Medical marijuana is already being recommended for glaucoma sufferers, as it can directly reduce the inflammation caused by the nerve damage and increased blood flow. However, since the relief is only temporary, some doctors believe that people need to partake every 2 or 3 hours (around the clock) to maintain a consistent eye pressure. This could lead to other health complications, making doctors more hesitant to recommend it. There is also a fear that glaucoma sufferers, without first consulting a doctor, might choose to self-medicate due to the belief that 'it can't hurt.' Marijuana does help ease the pain, but glaucoma is a progressive disease with no cure. Without a doctor's supervision, those who choose to self-medicate can harm the results of tests that could detect or track the progression of the disease.
High blood pressure is often a complication of Type 2 diabetes and, although medical marijuana does lower blood pressure, it also briefly elevates heart rate after smoking. As a result, marijuana isn't recommended for those with pre-existing heart conditions. However, studies have shown that prolonged marijuana users have a tolerance for these side-effects and have suffered no adverse effects of the briefly quickened heart rates.
Peripheral vascular disease is caused by atherosclerosis - the process in which fatty material builds up inside the arteries over time. This fatty material hardens as it mixes with calcium, scar tissue, and other materials, creating plaque on the arterial walls. This plaque can inhibit or completely block blood flow through the arteries. People with high blood sugar levels caused by diabetes can have narrow, weak blood vessels, in addition to accelerated fat levels in the blood, and higher blood pressure which dramatically affects the rate of developing atherosclerosis. All of this exponentially increases the chance of angina, heart attacks, and strokes.
Medical marijuana isn't recommended for sufferers of peripheral vascular disease. Although studies have shown that medical marijuana can significantly decrease angina, it can also cause acute coronary events. The increased heart rate, combined with the combustion inhalation of smoke, is thought to be one of the main reasons for the possible coronary complications and the lack of doctor recommendation. This has begun a debate of the use of synthetic cannabinoids, like Sativex and Marinol, versus hemp oil and vaporized medical marijuana.
Having received Drug Enforcement Administration approval of both synthetics, Sativex is approved by several countries as a treatment for pain and nausea of cancer patients. Marinol has been approved by the U.S. Food and Drug Administration as an anti-nausea solution for people with AIDS. Both synthetics have more severe side-effects than medical marijuana; thus, controversy exists about whether their use is as effective as vaporized medical marijuana or hemp oil. Neither Sativex nor Marinol have been studied for peripheral vascular disease or diabetes control.
There are many unknowns about the effects of medical marijuana for diabetes prevention and control, and studies are becoming harder to fund as the controversy of legality in the U.S. continues. With mid-term elections approaching, politicians seem to be wary of openly supporting legalized marijuana or studies for its various capabilities. However, research has already shown medical marijuana to be effective in treating not only diabetes, but also some, if not all, of its possible complications.