What is the effect of cannabis (marijuana) on diabetes mellitus?

From the Guidelines

People with diabetes should be advised to avoid using cannabis due to the potential risks of diabetic ketoacidosis, hyperglycemic ketosis, and cannabis hyperemesis syndrome, as well as the lack of regulation and standardization of cannabis products 1. The effects of cannabis on diabetes are complex and not fully understood, with both potential benefits and risks. Some studies suggest that cannabis use may improve insulin sensitivity and lower fasting insulin levels, potentially aiding in blood sugar control 1. However, cannabis use can also increase appetite, leading to overeating and poor food choices that negatively impact blood sugar levels. Additionally, cannabis use may impair judgment and reduce motivation for self-care activities essential for diabetes management, such as regular blood glucose monitoring, medication adherence, and exercise. Key considerations for people with diabetes who use cannabis include:

• The potential for increased risk of diabetic ketoacidosis and hyperglycemic ketosis associated with cannabis use 1
• The risk of cannabis hyperemesis syndrome, a condition characterized by cyclical vomiting episodes 1
• The lack of regulation and standardization of cannabis products, which can make it difficult to determine the potential risks and benefits of use 1
• The potential for interactions between cannabis and diabetes medications, which can affect blood sugar management 1 Overall, due to the potential risks and lack of regulation, people with diabetes should consult their healthcare provider before using cannabis for medical purposes, and should be advised to avoid using cannabis if possible 1.

Some important points to consider when discussing cannabis use with people with diabetes include:

• The importance of monitoring blood glucose levels and adjusting diabetes management plans as needed
• The potential for cannabis use to impair judgment and reduce motivation for self-care activities
• The need for education on the potential risks and benefits of cannabis use, as well as the importance of using cannabis products that are regulated and standardized
• The importance of coordinating food and cannabis use with diabetes medication regimens to minimize the risk of hypoglycemia and other complications 1

From the Research

Effect of Cannabis on Diabetes Mellitus

• The study 2 suggests that cannabinoids and terpenes found in cannabis may have a therapeutic effect on diabetes mellitus and its complications.
• Peripheral overactivation of the endocannabinoid system, particularly cannabinoid receptor 1 (CB1R) signaling, plays a crucial role in the progression of insulin resistance, diabetes, and its aging-related comorbidities.
• Phytocannabinoids such as cannabidiol (CBD) and tetrahydrocannabivarin (THCV) exhibit antagonistic activity on CB1R signaling and may serve as potential candidates for the treatment of diabetes and its complications.

Comparison with Other Therapies

• Studies 3, 4, and 5 discuss the importance of exercise in managing diabetes mellitus, but do not provide information on the effect of cannabis on diabetes.
• Study 6 evaluates the therapeutic effect of metformin monotherapy with metformin and acupuncture combined therapy on weight loss and insulin sensitivity in diabetic patients, but does not mention cannabis.

Key Findings

• The use of synthetic CB1R antagonists has been prohibited due to psychiatric side effects, but phytocannabinoids such as CBD and THCV do not show adverse side effects 2.
• Cannabinoids, terpenes, and flavonoids produced by cannabis may have therapeutic potential against insulin resistance, diabetes, and its complications 2.