Ask the Doctors

Dear Doctor: I have Type 1 diabetes and have used marijuana for years to control my blood sugar. I've seen my blood sugar drop 100 points in five minutes with marijuana, a lot faster than my Humalog insulin can manage. Why is that? Will medical marijuana ever go mainstream?

Dear Reader: Marijuana, or cannabis, contains more than 100 active chemical compounds. Known as cannabinoids, each of them behaves differently in the body. As the number of states that allow the use of cannabis for medical purposes continues to grow, so does the body of evidence that many of the compounds found within the plant have therapeutic potential. The most common use of cannabis in the United States right now is for pain control. It's also widely used for anxiety, to manage nausea and has been shown to be effective in reducing inflammation. It also shows promise in managing symptoms of neurological conditions like Parkinson's disease and multiple sclerosis.

The challenge to investigating medical claims regarding cannabis is the fact that, despite what's happening in individual states, it remains illegal at the federal level. Cannabis is a Schedule l drug, in the same category as heroin, which means research is subject to numerous restrictions. Even so, various studies and clinical trials are moving forward, and in time we will learn more about what cannabis can -- and can't -- do.

In researching your question regarding cannabis and diabetes, we found that you're not alone in noticing its effect on blood sugar. However, much of what we found is anecdotal evidence, which lacks scientific rigor. At this time, the study of cannabis and its potential effects on diabetes is in the early stages, with much of the work done in mice and on donated tissue samples. Until researchers are able to work extensively with human populations, the how and why of the effects of cannabis on the complex physiologic processes encompassed by diabetes will remain educated guesses.

Preliminary research suggests that certain cannabinoids may help with glucose control. Some studies have found that cannabis can have a positive effect on insulin resistance. A study published in 2016 in a journal of the American Diabetes Association found that THCV, one of the cannabinoids that are not psychoactive, improved glycemic control in some individuals with Type 2 diabetes. Another study that same year drew a link between cannabidiol, a compound in cannabis, and a decrease in inflammation of the pancreas. In an observational study using data from the federal Centers for Disease Control and Prevention, researchers found the incidence of diabetes among regular cannabis users to be measurably lower than that of the population at large. At the same time, the results of several other recent studies contradict a number of these pro-cannabis findings. So, basically, the jury is still out.

Although cannabis shows promise in the area of diabetes, science has yet to catch up with the claims being made. In the research that has been done, the reason for the effects of cannabis are not yet fully understood. Interest in the subject is strong, though, and continues to grow. We'll keep an eye on the topic for you and report back as we learn of new advances.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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