That sounds horrible. I have some info on diabetes I think could be useful to some patients here goes.Diabetes and Marijuana
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
Benefits of Cannabidiol (CBD)
Attenuates (slows the effects of) cardiac dysfunction, oxidative stress, fibrosis, and inflammatory and cell death signaling pathways in diabetic cardiomyopathy.
Retards beta cell (β-cell) damage in type 1 diabetes.
Manages obesity and its associated cardiometabolic sequelae, and should remain open for consideration.
Prevents type 1 in mice and protects against diabetic retinopathy in animals (American Diabetes Association funded a $300,000 study looking into it).
Decreases clot formation (an important consideration for people with diabetes at risk for heart attacks and strokes, especially if taking other “blood thinning” medications). Protects nerves and preserves retinal barrier.
Offers therapeutic opportunities for a variety of inflammatory diseases such as multiple sclerosis, rheumatoid arthritis, inflammatory bowel disease, atherosclerosis, allergic asthma, and autoimmune type 1 diabetes.
Has a therapeutic role in managing neurological complications of diabetes.
Tips for Use
Many people with and without diabetes, young and not, use marijuana. Compared with healthy youth, patients with diabetes use less tobacco, alcohol, and illicit drugs during the first years of adolescence but not later. Just like people who consume alcohol and may reap the benefits and risks of same, this is not intended to encourage anyone to fire up.
Watch for low glucose values and plan accordingly. Some patients report drops in glucose up to 40 mg/dL (2.2 mmol/L).
Watch for high glucose values and weight gain if you consistently get the munchies.
Use in moderation.
Stop use if interferes with your life, love/family or career, or other medical conditions.
Select cannabis buds that contain more than 4% Cannabidiol (CBD) by weight.
Get a vaporizer if you do smoke marijuana and want the cleanest form possible (search the Internet to find examples). That way, you will get the medicinal components without all the products of combustion. Edible forms are also available at most medical marijuana dispensaries.
Beware of websites that offer “legal” buds or marijuana substitutes as those products are not regulated and often include other non-studied, additive substances.
Depend on healthy eating, being active, taking medication, and healthy coping as the mainstays of a balanced diabetes self-management program. Marijuana is a complimentary and alternative medicine.
Marijuana remains illegal, although some states offer legal medical marijuana. The hope of therapeutic applications has lead to a resurgence of research activities. It will take decades before enough science has emerged to integrate into clinical practice guidelines, so the response from individual health practitioners will vary. An honest dialogue will better your chances of comprehensive care.
SOURCES:
The American Journal of Pathology. Neuroprotective and Blood-Retinal Barrier-Preserving Effects of Cannabidiol in Experimental Diabetes.
http://www.journals.elsevierhealth.com/periodicals/ajpa/article/S0002-9440(10)62086-X/fulltext (Accessed on 9/16/11).
Marijuana Research Today. Anticoagulant effects of a Cannabis extract in an obese rat model.
http://marijuana.researchtoday.net/archive/4/4/736.htm (Accessed on 9/16/11.)
National Center for Biotechnology Information. Cannabidiol attenuates cardiac dysfunction, oxidative stress, fibrosis, and inflammatory and cell death signaling pathways in diabetic cardiomyopathy.
http://www.ncbi.nlm.nih.gov/pubmed/21144973 (Accessed on 9/16/11.)
Lu, Dai, V. Kiran Vemuri, Richard I. Duclos, Alexandros Makriyannis, Jr. 2006. The Cannabinergic System as a Target for Anti-inflammatory Therapies: Current Topics in Medicinal Chemistry, Volume 6. Oak Park: Bentham Science Publishers.
National Center for Biotechnology Information. Cannabinoids and endocannabinoids in metabolic disorders with focus on diabetes.
http://www.ncbi.nlm.nih.gov/pubmed/21484568 (Accessed on 9/16/11.)
National Center for Biotechnology Information. Effects of rimonabant, a cannabinoid-1 receptor blocker, on weight and cardiometabolic risk factors in overweight or obese patients: RIO-North America: a randomized controlled trial.
http://www.ncbi.nlm.nih.gov/pubmed/16478899 (Accessed on 9/16/11.)
National Center for Biotechnology Information. The emerging role of the endocannabinoid system in endocrine regulation and energy balance.
http://www.ncbi.nlm.nih.gov/pubmed/16306385 (Accessed on 9/16/11.)
National Center for Biotechnology Information. Endocannabinoid control of food intake and energy balance.
http://www.ncbi.nlm.nih.gov/pubmed/15856067 (Accessed on 9/16/11).
National Center for Biotechnology Information. The endocannabinoid system, eating behavior and energy homeostasis: the end or a new beginning?
http://www.ncbi.nlm.nih.gov/pubmed/20347862 (Accessed on 9/16/11.)
National Center for Biotechnology Information. Isolation and structure of a brain constituent that binds to the cannabinoid receptor.
http://www.ncbi.nlm.nih.gov/pubmed/1470919 (Accessed on 9/16/11.)
Normal. Non-Psychoactive Cannabinoid Reduces Incidence Of Diabetes, Study Says.
http://www.norml.org/index.cfm?Group_ID=6909 (Accessed 9/16/11).
Science Daily. Marijuana Compound May Help Stop Diabetic Retinopathy.
http://www.sciencedaily.com/releases/2006/02/060227184647.htm (Accessed 9/16/11).
Science Direct. Neurobiology of Disease: The synthetic cannabinoid HU-210 attenuates neural damage in diabetic mice and hyperglycemic pheochromocytoma PC12 cells.
http://www.sciencedirect.com/science/article/pii/S0969996107000848#cor1 (Accessed on 9/16/11).
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NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.