Cannabis and Diabetes
Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. Lack of exercise, overweight and an unbalanced diet are a growing problem, especially in industrialized countries. The extent to which cannabis can be used as a therapeutic aid here is shown in the following article. There are over 400 million diabetics worldwide. Due to the unhealthy eating habits, diabetes type 2 is particularly common in Europe and is considered a civilization disease. About 80 percent of all diabetics are severely overweight. Obesity, lipid metabolism disorders, high blood pressure as well as a disturbed sugar metabolism are considered to be crucial risk factors for the development of diabetes.
Cannabis use as a trigger of diabetes ?
A few years ago cannabis was suspected to promote the onset of diabetes. US researchers found in a survey of cannabis users that many of these had developed pre-diabetes. In a pre-diabetes, the blood sugar level is indeed elevated, but it is still below the diabetes threshold. However, there was no evidence that cannabis use is directly related to diabetes, so the results of the survey were pushed to the dietary habits of high-sweet and diet-rich cannabis users. To date, there is no evidence that cannabis can cause diabetes. Rather, research has shown that cannabis users are less likely to develop diabetes. In addition, there is evidence that in particular the anti-inflammatory cannabinoid CBD may be able to delay the course of the disease of type 1 diabetes. The combination of CBD and THCV is believed to reduce liver fat build-up and decrease glucose intolerance, which could be beneficial for type 2 diabetes. However, before going any further into the research results, an overview of diabetes, which is often referred to as “diabetes”, follows. The reason for this is that diabetics excrete sugar in the urine without treatment. The sweetish taste of urine, the doctors used to diagnose diabetes. Although the medically correct term diabetes mellitus, in common parlance, the disease is still often called diabetes.
Diabetes is differentiated into type 1 and type 2. Compared to the rare type 1, type 2 is present in about 95 out of every 100 cases. In addition, there are the following special forms: Latent autoimmune diabetes with adult-onset (LADA) as a special form of type 1 diabetes, which occurs only in adulthood and in which the pancreas produces no or insufficient insulin. Maturity-onset diabetes (MODY), which is based on a genetic defect in the cells that produce insulin. This special form of diabetes usually occurs before the age of 25 and affects approximately one percent of all diabetics. Pancreatic diabetes occurs when the pancreas is damaged and partially or completely fails. Possible causes of this form of diabetes can be, for example, pancreatitis, chronic alcohol abuse, gallstones or pancreatic cancer. Gestational diabetes (gestational diabetes) affects about 4 out of 100 pregnant women. As a rule, this form of diabetes develops after the birth of the child.
Diabetes and its causes
Diabetes type 1 usually begins in adolescence and it is believed that this is an autoimmune disease. This means that the immune system turns against one’s own body. In addition, viral infections such as mumps or rubella as well as certain genetic factors are suspected to be the cause of diabetes. As for diabetes type 2, however, the cause is a disturbed insulin action on the cells. After a meal, the pancreas releases insulin. If a type 2 diabetes is present, the cells either do not respond adequately or do not respond to insulin because they have become resistant. For this reason, the blood sugar level in diabetics rises sharply after eating, because the body cells can not absorb the glucose from the blood. The causes of such insulin resistance can be a permanently increased intake of food, which then leads to elevated blood sugar levels. The increased glucose concentration in the blood reduces the number of insulin receptors, making them less sensitive to insulin. Although the pancreas forms insulin in type 2 diabetes, it also releases it into the blood, but due to insulin resistance, it is insufficient to lower blood sugar levels. It then comes to a relative insulin deficiency. Although insulin is present, the cells do not respond adequately. At the onset of the disease, the pancreas is still running at full speed, trying to balance the relative insulin deficiency to lower blood sugar levels. As the disease progresses, however, pancreatic function decreases, causing blood sugar levels to rise. In addition, genetic factors also play a role in type 2 diabetes. The risk of disease in children with a parent who suffers from type 2 diabetes is up to 50 percent.
Diabetes and its typical symptoms
At the onset of diabetes, little or no symptoms appear. Only at an advanced stage can complaints be expressed, such as:
- strong thirst
- blurred vision
- increased urination
- increased susceptibility to infection
- Diabetes mellitus type 1 and 2: symptoms
Type 2 diabetes mellitus usually causes no symptoms at the beginning, which is why it is usually discovered by chance later in the course of the disease during a routine examination or when secondary damage is already evident. As older people are much more likely to be affected by type 2 diabetes, this disease is colloquially called “old-age diabetes”. Meanwhile, however, more and more often younger people in this type of diabetes. By contrast, diabetes type 1 is more likely to affect adolescents. The symptoms of diabetes type 2 are also expressed later, and usually only when 80 percent of the insulin-producing cells in the pancreas have been destroyed by the disease. As a result, the pancreas can no longer compensate for the lack of insulin. Sometimes it can happen that the blood sugar levels in this type of diabetes rise very high, which can cause the person in a diabetic coma fall. Shortly before unconsciousness, sufferers usually perceive the smell of exhaled air after acetone (overripe fruit or nail polish remover).
Possible sequelae of diabetes
Over time, diabetes can lead to complications. To prevent these sequelae, it is important that diabetics consistently adjust their blood sugar and also pay attention to a healthy lifestyle. Diabetic microangiopathy (damage to the small blood vessels) If the blood sugar is permanently elevated and the blood sugar is not adjusted correctly, this can damage the small blood vessels. In the context of diabetic microangiopathy, bleeding can occur as the vessel walls become permeable. It is also possible thickening of the vessel walls, as a result of which it can lead to circulatory disorders and vascular occlusions. Diabetic microangiopathy develops particularly frequently in the following parts of the body or organs: The retina of the eye (diabetic retinopathy): If the small blood vessels in the eye are permanently damaged, the retina is poorly supplied with blood. The ocular fundus changes through the vascular changes and scars form, which in turn can lead to visual disturbances. Blindness is possible. Kidneys (diabetic nephropathy): The kidneys are also affected if the blood glucose levels are poorly adjusted over a longer period of time. Diabetic nephropathy is even a widespread secondary disease. In the worst case, such kidney damage can lead to kidney failure, which then requires regular dialysis (blood washing). There is also an increased risk of high blood pressure. Diabetic neuropathy Constantly elevated blood sugar levels also affect the nerves. If these are no longer adequately treated due to the damaged blood vessels, sensations such as tingling (“running ants”), altered temperature perception (feeling of cold feet), pain or burning on the affected parts of the body can occur. Especially in diabetics, the arms, legs and feet are affected by neuropathy.
Diabetic foot is one of the most common complications of diabetes. Thus, both nerve damage and circulatory disturbances in the feet can lead to wounds and ulcers that heal badly. Even the smallest injuries often result in lengthy complaints.
Diabetic macroangiopathy (damage to the large blood vessels)
Diabetes, when damaged by diabetes, can lead to a variety of cardiovascular diseases as it accelerates arteriosclerosis in the large blood vessels. The risk of arteriosclerosis increases in connection with various other diseases, such as myocardial infarction, coronary heart disease or stroke, as well as various risk factors such as obesity and smoking.
Menstrual disorders / Erectile Dysfunction
In women, the circulatory disorders and nerve damage that occur in the context of diabetes, menstrual disorders such as the absence of menstrual bleeding may occur. In men, it can lead to potency problems and erection difficulties.
Diabetes : diagnosis
The diagnosis is based on the blood sugar values. Normally, the blood glucose in blood plasma is below 100 mg / dL (5.6 mmol / L). After eating, the blood sugar does not rise higher than 140 mg / dl (7.8 mmol / l). Diabetes may be present if the following blood glucose levels are achieved: Occasional blood glucose greater than 200 mg / dL (11.1 mmol / L) and classic symptoms Fasting blood glucose above 126 mg / dL (7.0 mmol / L) HbA1c (long-term blood sugar) of over 6.5 percent OGTT-2-Hour-Value (glucose tolerance test) of more than 200 mg / dl Above a blood sugar level of approximately 180 mg / dl, the kidneys release the excess glucose via the urine (renal threshold). Therefore, a urine test can provide evidence of diabetes. The same applies to the presence of ketone bodies in the urine, which can also be detected via a urine test strip. However, such Urinstreifen are only rarely used for diagnosis.
Diabetes: therapy and treatment
Which therapy is used depends on whether type 1 or 2 diabetes is present. In both cases, however, the patient can significantly contribute to the success of the therapy by being responsible with his body. Although a diabetes illness is not curable, with the help of a suitable therapy the blood sugar level can be adjusted well. The consistent control of blood sugar also prevents secondary diseases.
Diabetes type 1: therapy
For type 1 diabetics, it is vital to regularly inject insulin. Short-acting insulin (insulin analogues) and long-acting normal insulin are available. Special diabetes medications (antidiabetics) are ineffective here.
Diabetes type 2: therapy
For diabetics of type 2, however, a wide range of therapies is available. Often, diabetes is related to obesity and obesity, so changing lifestyle and eating habits with exercise and a balanced diet is essential. In the early stage, a disturbed glucose metabolism can also be normalized frequently without appropriate medication. However, if these measures are not sufficient, oral antidiabetics are prescribed. If the medication is inadequate or the pancreas is depleted, insulin therapy may be needed to lower blood glucose levels. Depending on how far the diabetes has progressed, different levels of therapy may be required: Stage 1 (Basic Therapy): The patient is trained to change his lifestyle and diet. Medicines are not prescribed in the basic therapy. Stage 2: If the measures from the basic therapy do not achieve the desired results, additional medication is given to lower the blood sugar level. As a rule, it is the drug metformin. Stage 3: If the blood sugar level can not be lowered sufficiently using Level 1 and 2, a second drug or a therapy with insulin is used. Stage 4: For some diabetics, it makes sense to apply more insulin and combination therapy forms.
Diabetes: disease course and prognosis
Both the course of the disease and the prognosis depend on how well the blood sugar level can be adjusted in the long term. With early diagnosis and treatment, the prognosis is good. In contrast, a poorly adjusted blood sugar level reduces the quality of life and life expectancy. The disease process is also determined by the sequelae that occur through the damaged vessels. Stroke, heart attack and kidney failure are among the leading causes of death among diabetics.
Can medicinal hemp positively affect diabetes?
Researchers at the University of Nebraska reported in their 2013 study that there was little data on the relationship between metabolic processes in the body and cannabinoids. According to the researchers, epidemiological studies have shown lower prevalence rates of obesity and diabetes mellitus in cannabis users compared to those who have never used cannabis. This suggests a link between peripheral metabolic processes and cannabinoids. In this randomized, double-blind, placebo-controlled study, 62 patients with type 2 diabetes were treated with varying degrees of CBD and THCV doses for 13 weeks. Compared to the placebo group, THCV significantly reduced fasting plasma glucose and improved pancreatic cell function. According to the researchers, THCV may be a new therapeutic agent for glycemic control in patients with type 2 diabetes.
Cannabis against obesity?
A strong overweight is always associated with an increased risk of diabetes. Interestingly, studies have been conducted to investigate the association between obesity and cannabis use. Researchers at the University of California in 2006 found that there was no correlation between cannabis use and weight change. By contrast, the results of two large surveys conducted by the University at Buffalo and the Center for Addiction and Mental Health in Canada showed that cannabis users not only had a lower body mass index (BMI) but were also less affected by obesity non-consumers, even though cannabis users consumed more calories on average.
CBD as protection for type 1 diabetes?
The relationships between obesity, diabetes and cannabis are not yet clear. Nevertheless, cannabis seems to have effects on body weight. Evidence for this can be found in a study by the Nelson Mandela Metropolitan University in South Africa from the year 2012. After a cannabis extract was administered to overweight laboratory rats, a significant weight loss was seen. In addition, the pancreas gained weight. The researchers suggested that the pancreatic beta cells responsible for insulin production were still inexplicably protected by the cannabinoids. So, the results of this study could provide an approach to further research here, especially in relation to type 1 diabetes. The autoimmune reaction destroys the beta cells, potentially helping to stem the disease with cannabinoids. Interestingly, as early as 2008, researchers from the Hadassah Hebrew University Hospital in Jerusalem, following their research on non-obese and diabetic mice treated with CBD, noted that CBD may be used as a therapeutic agent for the treatment of type 1 diabetes could.
Cannabinoids for the Discomfort of Diabetic Polyneuropathy
Diabetic polyneuropathy is a potential consequence of diabetes. It is a nerve disorder that often affects the hands and feet but may affect any other part of the body. Pain and numbness are just a few symptoms that can cause such a nerve disorder. In 2009, University of Milano-Bicocca researchers investigated the analgesic effect of the cannabinoid cannabidiol (CBD) on rats suffering from diabetic polyneuropathy. The repeated administration of the CBD extract not only significantly alleviated the abnormal sensation of mechanical pain (allodynia) but also restored normal pain perception without inducing hyperglycaemia. Furthermore, the results indicate that the liver has been protected from oxidative stress, which seems to be an important factor in the development of polyneuropathy. We have already listed other interesting studies on the effects of cannabis on polyneuropathy in the article “How helpful is cannabis as medicine in polyneuropathy?”.
Cannabinoids for the treatment of diabetic retinopathy (DRP)
Retinal diabetic retinopathy (retinal microangiopathy) is the leading cause of middle-aged blindness in industrialized countries. Almost all diabetics are affected by it during their lifetime. It is believed that oxidative stress as well as various inflammatory immune responses play a significant role in retinal cell death. Researchers from the Department of Pharmacology and Toxicology Georgia administered cannabinoid CBD to diabetic lab rats in 2006. After treatment, neurotoxicity and oxidative stress were reduced. In addition, the concentration of tumor necrosis factor -a decreased. This is a substance that is involved in the inflammatory response and protects against the death of retinal cells. In 2010, scientists from the Department of Ophthalmology, also from the Medical College of Georgia, stated that the treatment options for diabetic retinopathy were limited. The discovery of new molecular entities with adequate clinical activity for diabetic retinopathy remains one of the major research priorities in ophthalmology. Focus on the therapeutic effects of cannabidiol (CBD) as a novel therapeutic modality in ophthalmology based on systematic studies in animal models of inflammatory retinal diseases including diabetic retinopathy. Particular emphasis will be placed on novel mechanisms that can provide preclinical insight into the pharmacological activity of CBD. These include a self-defense system against inflammation and neurodegeneration mediated by the inhibition of the equilibrating nucleoside transporter and the activation of the adenosine receptor by treatment with CBD. New study results of the researchers are not yet available. However, the results so far may be considered promising.