For people who have either Type 1 or Type 2 diabetes, how you use medical cannabis in relation to your condition can be important to consider. Ohio patients who use cannabis as part of the state’s Medical Marijuana Program talked to us about how they are managing their Type 1 diabetes.
World Diabetes Day: November 14th
World Diabetes Day became an official United Nations Day in 2006 with the passage of United Nation Resolution 61/225. It is marked every year on 14 November, the birthday of Sir Frederick Banting, who co-discovered insulin along with Charles Best in 1922.
It should be noted that World Diabetes Day is sponsored by pharmaceutical companies who make diabetes drugs, meaning cannabis gets left out of the conversation.
What is Diabetes?
Diabetes occurs when the body’s blood glucose, also called blood sugar, struggles to regulate itself, causing potentially dangerous complications in the nervous system, heart, blood vessels, and kidneys. While research is still scant, it’s thought that diabetics might utilize medical marijuana to help control the symptoms of their disease.
Two types of diabetes exist. Type 1 diabetes is a genetic condition. It often shows up early in life, whereas type 2 is mainly lifestyle-related and develops later. With type 1 diabetes, the pancreas doesn’t make insulin or makes very little insulin. Insulin is a hormone produced in the pancreas that helps blood sugar enter cells in the body to use as energy. Without insulin, blood sugar can’t get into those cells and builds up in the bloodstream, so synthetic insulin must be introduced to facilitate this process.
Type 2 diabetes, on the other hand, is an impairment in the way the body regulates and uses sugar (glucose) as a fuel, resulting in too much sugar circulating in the bloodstream. High blood sugar levels can lead to disorders of the circulatory, nervous and immune systems. The risk of developing type 2 diabetes increases with age, likely because people tend to gain weight and exercise less as they get older.
How Cannabis Might Help in Diabetes: By Type
Diabetes is a complicated disease. While we know that Type 1 (T1) is an autoimmune disease and Type 2 (T2) is a metabolic disorder, the causes of both types are not well understood. In the more common T2, it’s thought that endocannabinoid imbalance may be one of the reasons why patients have a hard time losing weight.
The endocannabinoid system plays a role in regulating energy homeostasis especially in the intra-abdominal adipose tissue. There’s evidence that the cannabis compound cannabidiol (CBD) may help to suppress appetite. It’s also thought that CBD might re-balance the endocannabinoid system by increasing the fat breakdown and mitochondria activities, which promotes metabolism and decreases fat storage. More research is needed, but study results are promising.
THC, CBD, THCV for Diabetics?
Diabetics may benefit from cannabis in different ways. Scientists suspect the THC enzyme may suppress autoimmune attacks so that less insulin is needed to lower the blood glucose levels. CBD has also been found to reduce the inflammation of pancreatic cells.
Interestingly, the compound of cannabis called THCV has also shown to improve glucose tolerance and increase insulin sensitivity for type 1 diabetic individuals. More about THCV and CBD’s potential role in diabetes here.
While exciting research continues to ramp up in this area, some Ohio patients are already using cannabis to help control their T1 diabetes as part of the state’s medical marijuana program. Here are a few of their stories*.
Amy C.’s Story
Amy C. was diagnosed with diabetes as a child back in the 1980s “when it was not really heard of T1 diabetes being diagnosed in adulthood.” As a T1 diabetic and advocate who educates others about this disease, Amy emphasizes the vast difference between T1 & T2 diabetes. “Lifestyle plays an important role in both.The difference is T1 cannot be prevented or solely managed by lifestyle choices. In T1, the body attacks the beta cells & kills them. Beta cells are responsible for secreting insulin. With T2, the body produces insulin, yet the body is resistant to the insulin as it is unable to utilize the insulin properly.” Amy explains that T2 diabetics often do end up on insulin and that can be for many reasons. This is one of the many myths and misconceptions regarding diabetes that she hopes to help dispel.
“As for cannabis and T1, it’s a truly complex thing that I have been trying to understand more of.” Unfortunately, due to lack of research, this puts Amy’s medical care team in the uncomfortable place of having to play a guessing game. “They can only recommend: ‘If it works, keep using it.’ We just cannot do the research to prove things.”
Amy notes that T1 diabetics are prone to mental health issues.
Amy notes that T1 diabetics are prone to mental health issues. “I developed CPTSD as a result of a conglomerate of things. When my sympathetic nervous system gets triggered, which in my case with autonomic neuropathy, a vagotomy, CPTSD, anxiety, among a slew of other things, it happens frequently and without an obvious trigger at times.”
“The awesome thing,” Amy says, “It is directly reflected in my Continual Glucose Monitor (CGM) readings as my body secretes glucose when in fight/flight mode. Today’s technology for T1 diabetes management provides the opportunity for my CGM readings to transmit via Bluetooth to my insulin pump, and the pump can increase/decrease my basal rate and even bolus if necessary. Cannabis helps reduce that sympathetic nervous system activation, helping to prevent mass amounts of glucose from being excreted into the bloodstream as the fight/fight mode kicks in.”
“Does this mean I don’t need insulin? Absolutely not. It is not a replacement for insulin at all as my body doesn’t produce insulin, making me insulin-dependent to remain alive. What it does mean for me is that managing CPTSD, anxiety, chronic pain, GI issues, etc. with cannabis helps me manage my T1 diabetes more easily. I’m not constantly chasing a number due to the newer technology with continuous glucose meters integrated with insulin pumps.”
Amy says that cannabis has definitely helped her a lot and she cannot wait for more research to be done. “I truly believe it would have helped me so much as a child when diagnosed also. I would probably still be on Total Parenteral Nutrition (TPN) or struggling with tube feed if not for cannabis too. It provided relief after so many surgeries and two sepsis episodes over the summer. It also gave me mad munchies which was so helpful because I had zero appetite going through everything.”
Products Amy Uses
As far as products, Amy finds the best relief from topicals & live concentrates, but uses flower too. “I look more for products with the terpenes that work for me: CBD, CBG, & CBN rather than THC %, indica, hybrid or sativa. Most of the time I am mixing a few different products to get the combination that works best for me as it’s hard to find high CBD strains in Ohio.”
Amy notes that having a nearby dispensary where she can legally purchase her medicine helps her feel more confident about it. “I’m hesitant to purchase medicine without testing, like at a gas station or random smoke shop.” Amy struggles with malabsorption due to gastroparesis so edibles and tinctures don’t work well for her. “I was started on RSO in 2017 when I went to Michigan with affirmative defense. The budtender recommended I use it rectally, which made sense as I use a lot of other rectal meds due to malabsorption. In 2011, I had a total hysterectomy & partial vaginectomy due to cancer. I remained stage 1 vaginal until my 2nd biopsy in 2018. I had been using RSO rectally up until that point & my vaginal biopsy came back negative.”
She now reports that she doesn’t have to see her gynecological oncologist. “I see a pelvic floor disorders specialist and he does a routine yearly vaginal smear, like a cervical pap smear but from my vagina as I don’t have a cervix anymore. There has not been ANYTHING show up since, meaning no more biopsies every 6 months.”
The biggest benefit Amy says that she has seen from cannabis is it has truly allowed her the opportunity to put herself first. “I wish research would catch up because cannabis has definitely helped me find my voice to speak up.”
Ryan M.’s Story
Ryan M., a Findlay, OH resident, has lived with Type 1 Diabetes for 29 years. He uses cannabis for his neuropathy and to aid in eating. Remarkably, his seizures also stopped when he started using cannabis. He had 47 seizures from ages 7-18 and zero since he began medicating with cannabis regularly.
The cannabis products Ryan uses vary based on his symptoms. He says he generally feels flower is effective, but he keeps RSO on hand for really bad days. “It’s hard to eat or move most times without flower. I doubt I’d eat without it, probably just fluids,” he reports. “I’ve tried concentrates but they seem to be more of a high if that makes sense and edibles don’t seem to work. I occasionally use a tincture but it depends if I can afford it.”
When it comes to flower strains, Ryan says that strains are still experimental to him but he likes GMO for pain and diesels or cakes for eating. “There’s a strain called Jenny Kush that I feel like is perfect but not in Ohio yet unfortunately. I’d like to stay with one brand but honestly money and availability play a big role. I’m a single dad with two kids so the cheaper the better if it’s still good. I appreciate you talking about the use of cannabis for diabetes. It’s literally saved my life and so many people are scared of it when it could be helping them.”
Cannabis for Diabetes: Safety Tips & Next Steps
T1 diabetics who use cannabis should keep these tips in mind when considering using cannabis as a treatment aid:
- If you plan on eating a meal or snack while you’re using cannabis, calculate your carbs ahead of time.
- Set frequent reminders to check your blood sugar and/or take your insulin.
- Do not consume alcohol and cannabis at the same time.
- Wear a diabetes alert tag or inform someone around you that you are diabetic.
- Talk to your care team about how often you use cannabis and discuss whether you need insulin adjustments.
MedicateOH honors and supports diabetes patients fighting this disease in Ohio and beyond. Are you a diabetic who’d like to try cannabis as a therapy? Reach out to us at medicateOH@gmail.com and we’ll connect you with local resources.
*Editor’s Note: Opinions and experiences in this article are shared directly from the patient and should not be construed as medical advice. Please consult your care team before starting any new treatment, including medical marijuana.
####
To help MedicateOH continue to bring you stories like this one, make a tax-deductible donation today:
