Cannabis Use in Type 2 Diabetes 

Could cannabis and/or CBD usage have an impact on type 2 diabetes, for good or ill?

The research published in the Journal of Diabetes Research studied the interrelation between using cannabis and developing type 2 diabetes. Beginning with 31,182 Swedish participants whose ages ranged from 18 to 84 in 2002, the study in 2010 reexamined the participants and finalized at 17,833 people with 7,533 males and 10,300 females. These participants were afterward categorized into either group based on their use of cannabis: never (no) and ever (past month, past year, and above a year back). 

Using a logistic regression model, the researchers found a relationship between people using cannabis and their chances of developing type 2 diabetes. After assessing the crude estimate, the study afterward examined the correlation between each agent and type 2 diabetes to scrutinize its possible impacts. Principally, the research suggests no particular connection between cannabis usage and the development of type 2 diabetes.

Cannabis users were reported to encounter some detrimental health-related behaviors, such as smoking tobacco (23.5%) and consuming a high alcohol level (41.3%). While having a lower BMI (<24.9%), users were prone to physically inactive with a lower career status in the past month. Using cannabis was inversely proportional with type 2 diabetes with OR = 0.68 (95% CI 0.47 0.99). After modifying for sex, the association witnessed OR = 0.65 (0.44 0.95); meanwhile, when age, BMI, tobacco smoking, and occupational position in the same model were altogether adjusted, there was a nearly identical result of 0.94 (0.63 1.42) as adjusting for age exclusively. 

Although having a lower BMI than non-users, cannabis users were proved to have no substantial changes to their weight during the period. Furthermore, other studies expressed the inverse correlation between cannabis and BMI; therefore, the impacts caused by BMI on cannabis-type 2 diabetes were somewhat uncertain. 

A study posed the question of whether phytocannabinoids are beneficial for obesity treatment. There are many diseases linked to insulin resistance and obesity; it is considered an alarming issue globally. Due to the nature of their effects on the body’s natural process, new therapeutic methods are being studied to treat various diseases. CBD already has various anti-inflammatory, anti-oxidant, and neuroprotective properties. There is more research in the future to see the effect on obesity. One of the derivatives, delta 9 of THC research, showed that it increases insulin sensitivity, decreases lipid accumulation, decreases fasting plasma glucose, and decreases weight gain. CBD has other effects such as lipolysis, increased mitochondrial activity, decreased oxidative stress, cardiac fibrosis, and increased energy expenditure.

In conclusion, because insulin resistance and obesity are an epidemic, research is examining other options that may curb these debilitating diseases. CBD is a possible adjunct therapy for a patient to lose weight with its several positive effects on the liver, heart, adipose tissue, and pancreas. Those effects include increased insulin sensitivity, decreased lipid accumulation, decreased fasting plasma glucose, and decreased weight gain. Therefore, it was concluded that CBD is a promising potential therapeutic agent and might be effective for insulin resistance, type 2 diabetes, and metabolic syndrome. 

Nonetheless, some limitations can still be observed through this research. The detailed information regarding the frequency and duration was not listed; meanwhile, the categories of time spent on consuming cannabis are elementary. The sample was considered insufficient; therefore, a relationship between cannabis use and type 2 diabetes development could still be possible. Moreover, feasible deficient self-reports, plus the potential decrease of cannabis’ effects when categorizing the frequency, might negatively affect the results.

Practice Pearls:

• People using cannabis were shown to have a lower BMI when compared with non-users, at about 34%.
• Cannabis users had higher rates of factors such as tobacco and alcohol, generating negative consequences in their physical activities and occupational positions.
• With no participants developing type 2 diabetes initially, the study illustrates no significant association between using cannabis and developing this disease.

K. Danielsson, A. Lundin. Cannabis Use as Risk or Protection for Type 2 Diabetes: A Longitudinal Study of 18 000 Swedish Men and Women. Journal of Diabetes Research. 2016 October 24.

P. Bielaweic, E. Harasim-symbor Phytocannabinoids: Useful Drugs For the Treatment of Obesity? Special Focus on Cannabidiol. Frontiers in Endocrinology. 2020 March 4.

Idris Aderoju, Pharm.D. Candidate, Florida A&M University