Over the last few decades a continuous increase of studies have been, and are currently, being carried out regarding the effects of cannabis in different health conditions.  Several studies have shown that there are potential positive effects of medical cannabis in diabetes, however, further research is still being carried out to investigate its full potential as diabetes can be seen as a complicated disease.

What is diabetes?

Diabetes is a metabolic impairment in the body characterized by high blood sugar levels  resulting from deficiency in insulin action, secretion or both.  Insulin is a hormone produced by the pancreas which helps to transfer the glucose from food into the cells to produce energy.

Diabetes can lead to long-term complications such as loss of vision, organs, nerves and also blood vessels failure due to the glucose not being broken down properly, causing it to build up in the blood.  In some serious cases, it can lead to amputation and death.  Diabetes can be classified into two types:

  • Type 1 diabetes (T1D): Type 1 diabetes is the complete destruction of pancreatic b-cells (insulin secretors). This results in the body producing absolutely no insulin at all.  This is quite a rare case as only 5-10% of diabetics have type 1 diabetes.  In some cases, this can be hereditary.
  • Type 2 diabetes (T2D): Type 2 diabetes either produces insufficient insulin, or insulin that does not work effectively. Essentially, this means that there is either insulin resistance or have a considerable amount of insulin deficiency. This accounts for 90-95% diabetics.

Although the cause of T1D is not completely clear yet, T2D can be influenced by lifestyle choices such as physical activity and eating habits which can go unnoticed for years[1].

The Endocannabinoid System and medical cannabis in diabetes

According to data, it was discovered that the endocannabinoid system (ECS) contributes to the beta cell loss in T2D by regulating the cell death process and inflammatory process, eventually playing a role in the development of insulin resistance[2].  This is due to the ECS playing a vital role in the developmental of obesity and in glucose and lipid metabolism.

The ECS consists of cannabinoid receptors (mainly type 1 and 2, or CB1 and CB2 ), ligands or endocannabinoids (ECs), and the enzymes responsible for synthesis and degradation of ECs[3].

While investigations are still being carried out with the relationship between cannabis and diabetes, there have been a few revelations already.  In a study with humans, it was found that lifetime and 12-month cannabis users indicated a decreased likelihood of diabetes against non-cannabis users.   For now, it is still too early to suggest its protective effects and more, however, more research must be invested in this area[4].

In a study including obese US adults aged 18 to 59 years old, they had found that lifetime marijuana use was significantly associated with lower fasting insulin and homeostasis model assessment of insulin resistance in obese individuals.

Additionally, this study found that even at a low frequency of cannabis usage (less than four uses per month), some results still showed when comparing individuals’ insulin levels. Finally, previous consumers who used it almost throughout their lifetime had presented significantly lower insulin concentrations compared with those who never used cannabis[5].

Diabetes type 2 and phytocannabinoids (CBD and THCV)

Another clinical study investigated the effects of cannabidiol (CBD) and tetrahydrocannabivarin (THCV) in subjects with type 2 diabetes. CBD and THCV are both nonpsychoactive phytocannabinoids involved in glucose and lipid metabolism in animal models.

Results described that THCV improved glycaemic control which showed potential in a possible treatment. CBD did not show any metabolic effects, but diminished circulating resistin concentrations and increased the circulating glucose-dependent insulinotropic polypeptide (GIP). High levels of resistin are linked with obesity and insulin resistance, while GIP is a hormone which have stimulating activity of insulin and pancreatic b-cell–preserving properties[6].

Diabetes type 1 and phytocanabinoid (CBD)

A different study on mice provided further evidence of the anti-autoimmune effects of CBD, suggesting that the treatment with CBD inhibits diabetes by reduction of pro-inflammatory (IFN-g and TNF-a) molecules, and augmentation of anti-inflammatory (IL-4 and IL-10) substances.  In addition, CBD treatment reduced insulitis (the relating hallmark of T1D, an inflammatory injury around beta cells caused by immune cells infiltration). These results indicate that CBD can decrease diabetes occurrence by an immunomodulatory mechanism[7].

Conclusion

In general, the data about medical cannabis in diabetes presented herein suggest that THCV or CBD might be effective for T1D or T2D. However, further investigation is needed to establish the correct mechanism that may lead to clinical application.

Did you like the post? Give us some feedback! This post has been done based on existent research to the date of publication of the article. Due to the increase in studies based on medical cannabis, the information provided can vary over time and we’ll keep informing in further writings.

[1] American Diabetes Association. Diagnosis and classification of diabetes mellitus [published correction appears in Diabetes Care. 2010 Apr;33(4):e57]. Diabetes Care. 2010;33 Suppl 1(Suppl 1):S62–S69. doi:10.2337/dc10-S062

[2] Gruden, G., et alt. (2016). Role of the endocannabinoid system in diabetes and diabetic complications. British journal of pharmacology, 173(7), 1116–1127. doi:10.1111/bph.13226

[3] Nguyen, T., et alt. (2019). Overcoming the Psychiatric Side Effects of the Cannabinoid CB1 Receptor Antagonists: Current Approaches for Therapeutics Development. Current topics in medicinal chemistry, 19(16), 1418-1435.

[4] Imtiaz, S. and Rehm, J. (2018). The relationship between cannabis use and diabetes: Results from the National Epidemiologic Survey on Alcohol and Related Conditions III. Drug Alcohol Rev., 37: 897-902. doi:10.1111/dar.12867

[5] Ngueta, G, et alt. 2019. Lifetime marijuana use in relation to insulin resistance in lean, overweight, and obese US adults. Journal of Diabetes. 1– 10. https://doi.org/10.1111/1753-0407.12958

[6] Jadoon, K. A., et alt. (2016). Efficacy and Safety of Cannabidiol and Tetrahydrocannabivarin on Glycemic and Lipid Parameters in Patients With Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Pilot Study. Diabetes Care, 39(10), 1777–1786. doi:10.2337/dc16-0650

[7] L. Weiss, et alt. (2006) Cannabidiol lowers incidence of diabetes in non-obese diabetic mice, Autoimmunity, 39:2, 143-151, DOI: 10.1080/08916930500356674