For residents of Colorado and Washington state, 2014 brought a profound legal and societal change. Marijuana is now available, legally, in both of those states. While the drug is cleared for medical use elsewhere, and other jurisdictions have decriminalized it, these two states have taken the profound, extra step of full legalization.
So what does this new, widespread sale of pot mean for people with diabetes? On one hand, you might expect that it would cause problems. Most people have heard (or experienced first-hand, although we won’t be taking names here) of the “munchies.” How could that possibly be good for folks watching their blood sugar? Surprisingly, research suggests otherwise.
Marijuana actually appears to have metabolic benefits. A study published last summer in The American Journal of Medicine looked at more than 4,500 adults, of whom 579 were using marijuana at the time. That subgroup had notably better fasting blood glucose levels, insulin resistance, and waist circumference.
According to the study’s abstract: “current marijuana use was associated with 16 percent lower fasting insulin levels . . . and 17 percent lower HOMA-IR (insulin resistance). . . . We found significant associations between marijuana use and smaller waist circumferences.”
Murray Mittleman, associate professor of medicine at Harvard Medical School and the study’s lead author, told Time magazine last year that “the most important finding is that current users of marijuana appeared to have better carbohydrate metabolism than nonusers.”
Why does marijuana have these effects? Scientists aren’t quite sure. The study was not a controlled trial–participants were simply asked about marijuana use–so other factors beside the drug could be in play. It may be, for instance, that people who use marijuana are more likely to exercise vigorously (although it doesn’t seem likely).
What is known with confidence is that pot affects areas of the brain called cannabinoid receptors. And as attacks of “the munchies” have shown, those receptors play a big role in appetite and metabolism.
In fact, the drug rimonabant was developed to affect those very same receptors–but in a different way than marijuana. The drug was effective at cutting weight and fasting blood glucose levels in users, but it was ultimately taken off the shelf in Europe because of psychiatric side effects. It was never approved for use in the United States.
When you take last summer’s study and rimonabant into account, it’s clear that marijuana plays an intriguing role in the body’s insulin regulation. While the federal government has made studying marijuana difficult–it’s still illegal on the national level–the spread of relaxed state laws and natural scientific curiosity suggests that we’ll be hearing more about this subject in the future. In a few decades, some sort of marijuana derivative may be part of the everyday health regimen for people with diabetes.
If that sounds preposterous, just remember that the United States prohibited manufacture and sale of alcohol from 1920 to 1933. Since then, doctors have found that red wine has real health benefits, and older adults are often encouraged to drink a glass a day.
Times can change, and change quickly.