Diabetes and Marijuana

The surprising conclusion.

Theresa Garnero By Theresa Garnero, APRN, BC-ADM, MSN, CDE

Marijuana plants (Cannabis sativa) may play a role in preventing and controlling diabetes, and treating diabetes complications according to several research articles.

That is the surprising conclusion reached after reviewing some science on the subject in order to answer questions along the lines of, "Will pot make my diabetes worse?" Politics and legalization issues aside, this article will highlight some of the findings. It does not suggest you start using marijuana or condone its use.

Terminology
For the purpose of discussion, the research on marijuana and diabetes focuses on a compound in Cannabis called Cannabidiol (CBD).

CBD has medical effects but does not make people feel "stoned." It actually counters some of the disconcerting effects of euphoria or lethargy associated with another substance found in Cannabis called Tetrahydrocannabinol (THC). After decades in which only high-THC Cannabis was available, CBD-rich strains are now being grown by and for medical users and may make it a more appealing treatment option. More than 25 CBD-rich strains have been identified, according to Project CDB, a nonprofit educational service dedicated to publicizing research into the medical utility of CBD and other components of the Cannabis plant.

Another important term to understand is endocannabinoids. "Endo" meaning inside, and cannabinoid — a chemical compound found in receptor sites of the nervous and immune systems. These receptors are in high concentrations in the brain, liver, muscle, gut, and fat tissue. Endocannabinoids are known as the brain's "chemical marijuana." Following, we explore the novel aspect of endocannabinoid system (ECS) research and the biological effects of plant cannabinoids as it relates to diabetes.

The Brain's Own "Chemical Marijuana" Affects Metabolism and Glucose Control
Recent studies suggest that endocannabinoids may be a factor linked to metabolic syndrome. Endocannabinoid receptors have been identified in areas of the body responsible for modulating energy balance, feeding behavior, and glucose control.

Endocannabinoid stimulation leads to weight gain, insulin resistance, abnormal lipids (blood cholesterols), and impaired glucose tolerance. Overactivity of this system has been found in human obesity and in animal models of genetic and diet-induced obesity. So why not block this activity? Been there, done that — it was not safe.

The treatment with a specific endocannabinoid inhibitor drug, Rimonabant, showed incredible promise, but because of significant safety issues, is no longer available. In clinical trials, it reduced excess body weight; lowered blood pressure in hypertensive patients; improved insulin sensitivity, glucose control and A1C levels; corrected dyslipidemia; and decreased the prevalence of metabolic syndrome. The SERENADE (Study Evaluating Rimonabant Efficacy in Drug-NAive DiabEtic Patients) trial was a 6-month, multi-center/country, randomized, double-blind, placebo-controlled, parallel-group study comparing rimonabant 20 mg once daily to a placebo on top of diet and exercise. Rimonabant lowered A1C and other important cardiovascular endpoints, but had serious side effects. These included increased risk for severe depression leading to suicide and development of neurodegenerative diseases such as Multiple sclerosis, Parkinson's disease, Alzheimer's disease, Huntington's disease, and Amyotrophic Lateral Sclerosis (ALS).

Since it was pulled from European markets and was never approved by the FDA in the U.S., the best remaining option to maximize the endocannabinoid pathway is with Cannabidiol (CBD) use.

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Last Modified Date: July 10, 2013

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