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Cannabis and Diabetes

Cannabis, or marijuana, is a drug derived from the cannabis plant that is used for recreational use, medicinal purposes and religious or spiritual rites.

Cannabis plants produce a unique family of compounds called cannabinoids. Of these, the major psychoactive (brain function-affecting) compound is tetrahydrocannabinol (THC).

Marijuana contains high levels of THC, as well as other psychoactive chemicals, which produce the ‘high’ users feel when inhaling or ingesting it.

Two other compounds, tetrahydrocannabivarin (THCV) and cannabidiol (CBD) have been shown to have benefits for blood sugar control and metabolism in diabetes studies.

Legalisation on the NHS

On 1 November 2018 medical cannabis products were made available on the NHS for some people in the UK.

Treatments can only be prescribed by specialist doctors in a limited number of circumstances and not by GPs.

The treatments will contain varying quantities of THC and CBD. Treatments will include pills, capsules and oils but smoking cannabis will not be prescribed.

People who stand to benefit will be children with rare, severe forms of epilepsy, adults with vomiting or nausea caused by chemotherapy, and adults with muscle stiffness caused by multiple sclerosis.

History of cannabis

Cannabis has been used by humans for thousands of years, with the earliest record of its use dating back to the 3rd millennium BC.

It is indigenous to Central and South Asia, and is believed to of been used by many ancient civilizations, particularly as a form of medicine or herbal therapy.

Cannabis and its effect on diabetes

There is growing research investigating cannabis use and the effects on diabetes.

Possible benefits of cannabis

A number of animal-based studies and some human studies have highlighted a number of potential health benefits of cannabis for diabetes.

Research by the American Alliance for Medical Cannabis (AAMC) has suggested that cannabis can help:

  • Stabilise blood sugars – a large body of anecdotal evidence is building among people with diabetes to support this.
  • Suppress some of the arterial inflammation commonly experienced by people with diabetes, which can lead to cardiovascular disease
  • Prevent nerve inflammation and ease the pain of neuropathy – the most common complication of diabetes – by stimulating receptors in the body and brain.
  • Lower blood pressure over time, which can help reduce the risk of heart disease and other diabetes complications
  • Keep blood vessels open and improve circulation.
  • Relieve muscle cramps and the pain of gastrointestinal (GI) disorders
  • Be used to make topical creams to relieve neuropathic pain and tingling in hands and feet

Cannabis compounds have also been shown to reduce intra-ocular pressure (the fluid pressure within the eye) considerably in people with glaucoma – a type of eye disease that is caused by conditions that severely restrict blood flow to the eye, such as severe diabetic retinopathy

Insulin benefits

THCV and CBD have been shown to improve metabolism and blood glucose in human and animal models of diabetes.

A 2016 study found that THCV and CBD decreased blood glucose levels and increased insulin production in people with type 2 diabetes, indicating a “new therapeutic agent for glycemic control”. [356]

Previously, tests in mice have shown the compounds boosted metabolism, leading to lower levels of cholesterol in the blood and fat in the liver.

UK-based company GW Pharmaceuticals is currently in the process of developing a cannabis spray called Sativex, a prescription medication used to treat muscle spasms in multiple sclerosis. GW is aiming to utilise the CBD and THCV compounds in the product to help with blood sugar regulation in people with type 2 diabetes.

Meanwhile, a separate 2017 study found that cannabis use was linked with lower insulin resistance in a cohort of people with and without diabetes. [357]

Treatment for inflammation

CBD has long been known to possess anti-inflammatory properties, and because chronic inflammation is known to play a role in the development of insulin resistance and type 2 diabetes, research is investigating its efficacy in reducing inflammation in diabetes.

A 2017 study by the Medical College of Georgia revealed that CBD treatment reduced inflammation in animal models of diabetes, concluding “the nonpsychotropic CBD is a promising candidate for anti-inflammatory and neuroprotective therapeutics”. [358]

In 2015, Israeli researchers at the Hebrew University of Jerusalem reported that the anti-inflammatory properties of CBD, could treat different illnesses such as diabetes , atherosclerosis and cardiovascular disease.

In August 2015, cannabis pills containing only CBD, and not THC, were sold legally in Europe for the first time.

Treatment for peripheral neuropathy

Peripheral neuropathy is another complication reported to be eased by cannabis.

The Medical College of Georgia Study in 2017 also revealed that CBD treatment reduced the severity of diabetic retinopathy in diabetic animal models.

Another study in 2015 saw University of California researchers gave 16 patients with painful diabetic peripheral neuropathy either placebo, or single doses of cannabis, which varied in dose strength.

Tests were first performed on baseline spontaneous pain, evoked pain and cognitive function. The higher the content of THC participants inhaled, the less pain they felt

Treatment for obesity

Furthermore, GW Pharmaceuticals research has revealed that cannabis could be used to treat obesity-related diseases such as type 2 diabetes by increasing the amount of energy the body burns

In December 2014, cannabis was linked to a lower likelihood of obesity, lower BMI and reduced risk of type 2 diabetes in an Inuit population.

Cannabis drug class

Laws regarding the production, possession, use and sale of cannabis came into effect in the early 20th century.

But despite being illegal in most countries, including the UK, its use as a recreational drug is still very common.

In fact it is the most used illicit drug in the world, according to the United Nations, with approximately 22.5 million adults across the globe estimated to use marijuana on a daily basis.

Legal status

In the UK, cannabis is categorized as a Class B drug under the UK Misuse of Drugs Act.

Individuals caught in possession of marijuana are therefore given more lenient punishment – often confiscation and a ‘cannabis warning’ for small amounts.

Effects of cannabis

Cannabis causes a number of noticeable but mild (in comparison with other recreational drugs) physical and mental effects. These include:

  • Increased pulse rate
  • Dry mouth
  • Increased appetite
  • Bloodshot eyes
  • Light-headiness
  • Occasional dizzy spells
  • Problems with memory, concentration, perception and coordinated movement

Pro-cannabis groups and campaigners often highlight its pain relief benefits and stress the fact that not one cannabis-related death has ever been recorded.

Treatment for peripheral neuropathy

Another study in 2015 saw University of California researchers gave 16 patients with painful diabetic peripheral neuropathy either placebo, or single doses of cannabis, which varied in dose strength.

Tests were first performed on baseline spontaneous pain, evoked pain and cognitive function. The higher the content of THC participants inhaled, the less pain they felt

Negative effects of cannabis

Studies that have investigated this subject suggest that cannabis can have a number of effects on blood glucose control, depending on dosage. These include:

  • Memory and concentration-related problems which may affect glycemic control.
  • Raised appetite, or ‘munchies’ – a craving for sweet/fatty food, which can subsequently lead to hyperglycemia (abnormally high blood sugar levels)
  • Impaired glucose tolerance and hyperglycemia when heavily used.

Experts from Diabetes New Zealand, a national non-profit organization, also claim that cannabis indirectly affects blood glucose levels due to the drugs’ effect on the brain, which they say can lead to users not recognizing symptoms of hypoglycemia (low blood sugar) or confusing such symptoms with the effects of the drug.

People who use Low Carb Program have achieved weight loss, improved HbA1c, reduced medications and type 2 diabetes remission.

Indica or Sativa for high blood pressure?

High blood pressure is a health concern that affects millions of people worldwide. In addition to increasing your chances of a heart attack, it elevates your stroke and aneurysm risk. With that in mind, it makes sense that those who suffer from hypertension are often trying to find ways to tackle it. Those who prefer to take a natural approach to their health may wonder “Does cannabis lower blood pressure?”

Unlike other areas of medical cannabis research, the answer to this question isn’t so straight forward. The links between cannabis and blood pressure can vary according to the type you’re using. Additionally, the immediate effects of using cannabis can vary when compared with the long-term effects. To develop a better understanding, it’s worth learning more about the different strains. Additionally, you need to know more about how to use Indica or Sativa for high blood pressure.

First, what is high blood pressure?

Ideally, your blood pressure will be between 90 to 120 systolic and 60 to 80 diastolic. When it moves into the 120 to 140 systolic camp, it’s classed as pre-hypertension. At 140+, you’re hypertensive. If you present to a physician with high blood pressure, they’ll probably want to read yours on more than one occasion to make sure what they’re seeing is accurate.

The causes of high blood pressure aren’t always clear. Most people have primary hypertension, for which there’s no real traceable cause but plenty of lifestyle factors might contribute. A small number suffer from secondary hypertension, which can arise following kidney disease and other contributory conditions.

If you do develop high blood pressure, you may find that you’re asked to take diuretics, ace inhibitors, calcium channel blockers, or a combination of the three. The type you’ll need to take will vary according to your age and race, as variations between the two may mean you don’t respond well to certain treatments.

Do cannabis and blood pressure mix?

Cannabis and blood pressure can have a positive relationship, but that might not be your first experience when you use it. According to one study , using cannabis initially results in a small but noticeable rise in heart rate and blood pressure. This rise depends on how much you’re using. The more you use, the higher that rise will be.

It’s possibly worth recognizing that your mode of using cannabis will also influence this. For example, if you choose to smoke it alongside a nicotine-based product you’re introducing your body to other substances that increase blood pressure. Therefore, if you’re serious about using marijuana for this purpose, you’ll stay away from additives that could render your efforts pointless.

Does cannabis lower blood pressure at all?

If you’re wondering “Does cannabis lower blood pressure?” the simplest answer is: yes. However, as we’ve already discussed above, the effects aren’t immediate.

As this study details , cannabis contains multiple compounds and has numerous mechanisms of action that allow it to lower blood pressure. First, there may be some localized cannabinoid receptors on the myocardium (the heart’s muscle) that respond to cannabinoids by slowing your heart rate down. At the same time, the CBD element of your cannabis may execute some cardioprotective factors. So, as you slow your heart rate down, you’ll also protect it against future heart attacks.

The same study also suggests that cannabinoids can influence your blood pressure via the autonomic nervous system. This is the part of the nervous system that automatically responds to changes in your environment, causing your blood pressure to rise and fall. By moderating it with CBD, you could change your blood pressure for the better.

Can you use Indica or Sativa for high blood pressure?

With all this in mind, you’ll now want to know whether to use Indica or Sativa for high blood pressure. As with many elements of medical cannabis, this is an area that’s largely under-studied. However, there are some studies we can turn to that offer useful advice.

This study focused on the use of THC-dominant marijuana in patients with glaucoma who were at risk of losing their eyesight due to rising intra-ocular pressure. Initially, the study participants saw a marked increase in their blood pressure. After a short while, their systolic and diastolic pressure fell, suggesting that the THC present in cannabis can lower blood pressure. As Sativa strains of cannabis have a higher THC content that Indica strains, this suggests it could lower blood pressure within moments of using it.

Another study that takes a different approach looks at the rises in blood pressure among those who abruptly stop using cannabis. Those who chose to stop their daily cannabis habit found that their blood pressure rose by more than 20mmHg at the systolic value, which is the value that carries the most risk. The study’s conclusion was that those who want to stop using cannabis should be monitored to ensure there’s no dangerous rise in blood pressure, suggestions that using it does come with some cardio-protective benefits.

Not-so-surprisingly, there’s more research examining the effects of CBD on hypertension. This study identified how CBD-dominant strains of marijuana, which often means Indica-dominant strains, resulted in vasodilation in rats. As you’re likely aware, narrow and stiffening arteries make a significant contribution to hypertension. If CBD produces a vasodilating effect, this also means your heart isn’t having to pump as hard against your blood vessel walls to send blood around your body. As a result, your blood pressure lowers.

A further study has identified how CBD can cause bradycardia in animals that are conscious. Bradycardia is a state in which your heart rate slows below the average range for an adult. Unless you’re in a hypotensive state, your blood pressure usually lowers too. However, it’s worth noting that while this can mean lower blood pressure, using CBD to the point you become too bradycardic may also lead to your body trying to compensate by raising your blood pressure again.

Overall, it appears Indica is the better choice

Because there is more research confirming the benefits of Indica versus Sativa for high blood pressure, it does appear that it’s the better choice here. Indica often has a higher CBD value than Sativa, and this appears to have the greatest therapeutic benefit in treating conditions such as high blood pressure.

With evidence suggesting that cannabis can lower blood pressure, it’s worth considering among those who are struggling to lower theirs. In addition to acting directly on the heart’s muscle, it also provides it with a small degree of protection. Its vasodilatory effects may result in blood pressure lowering further. If you’re willing to focus on lifestyle factors, it’s worth considering whether the stress-reduction element of using medical cannabis can make your blood pressure less pronounced.

Although research into this area is relatively scant, most of the material that does exist focuses on CBD rather than THC. As such, it may be the case that Indica is the better choice, especially if you want to avoid moderate rises in your blood pressure upon using it. As with any element of your health, avoid stopping your current regime without advice from your doctor. If you do experience high blood pressure, discuss it with a physician before self-medicating.