Marijuana and Diabetes: What You Need To Know
Key takeaways:
- Medical marijuana is legal in many U.S. states and may help with some aspects of diabetes like sleep, pain relief, nausea, and muscle spasms.
- How marijuana interacts with diabetes isn’t fully understood – some studies show improvements in insulin resistance, while other research finds an increased risk of a higher A1C.
- If you choose to use marijuana, watch out for side effects like high blood sugar, nausea, and vomiting, which can be signs of DKA or cannabis hyperemesis syndrome.
Diabetes management and glucose levels are impacted by many factors. Everything from the food you eat to physical activity, sleep, and stress can influence blood sugar levels.
Cannabis (also known as marijuana or weed) is one of these factors. While recreational or legalized medical marijuana can be used safely, it’s important to be aware of how it can impact your health.
Some research suggests marijuana could have potential benefits for diabetes, like improved blood sugar regulation and insulin resistance, while other research finds it can have negative effects. Here’s what the latest science has to say.
What is marijuana?
Marijuana is a substance that comes from the plant Cannabis sativa. There are two key chemicals found in the cannabis plant: tetrahydrocannabinol (THC), which has psychoactive properties that cause changes in your brain (what people often refer to as getting “high”), and cannabidiol (CBD), which interacts in the body but isn’t psychoactive. CBD and THC work differently in the body but can have beneficial effects, especially when used together.
Dr. Jay Shubrook, professor of primary care at Touro University California, said that medical marijuana is well-known to help manage several conditions: muscle spasms, pain (for example, nerve damage from peripheral neuropathy), and reducing nausea and other side effects from chemotherapy treatment.
Shubrook said that medical marijuana should be used with caution in people who are above age 65, are pregnant, or have a mental health condition like depression, post-traumatic stress disorder, or bipolar disorder. While studies are promising, more research is needed on the potential of medical marijuana for sleep disorders, irritable bowel disease, and cancer treatment.
Is marijuana legal?
While not federally legal in the U.S. yet, medical and recreational marijuana is legal in many states. As the name implies, medical marijuana is used for a specific health condition and must be prescribed by a doctor. You can have medical marijuana products mailed or pick them up at a medical marijuana dispensary. Recreational marijuana can be purchased at any legal dispensary and does not require a prescription.
Currently, medical marijuana is legal in 38 states, the District of Columbia, and four out of five U.S. territories. Marijuana is legal for recreational use in 24 states.
How does marijuana affect diabetes?
Researchers don’t fully understand how cannabis affects blood sugar. A review article found higher A1C levels among people with type 1 diabetes who used cannabis recreationally. Meanwhile, another study on U.S. adults without diabetes found that marijuana tended to have a positive impact and lower insulin resistance.
Marijuana could also impact body weight, but the results are mixed. One study found that recreational marijuana users had a smaller waist circumference, which could indicate a lower body fat percentage. However, cannabis use can also lead to cravings – aka “the munchies” – for carb-heavy foods, which can cause people to consume additional calories and gain weight. In people with diabetes, the munchies could also lead to high blood sugar.
However, Shubrook said most people with diabetes report a minimal effect on their blood glucose levels. Cannabis is also less likely to affect glucose than many other substances.
Is marijuana safe to use if you have diabetes?
While cannabis is safe for many people to use, there are side effects people with diabetes should be aware of including high blood sugar, anxiety, and risk of substance abuse.
Dr. Halis Akturk, associate professor of medicine and pediatrics at the University of Colorado, has been studying the effects of cannabis in people with diabetes for years and said it can also trigger medical emergencies like diabetic ketoacidosis (DKA) and cannabis hyperemesis syndrome.
Diabetic ketoacidosis
DKA is a serious, and potentially life-threatening diabetes complication that can occur when a person doesn’t have enough insulin. Symptoms of DKA may include nausea, vomiting, abdominal pain, lethargy, and even coma.
Research has found that moderate marijuana use in people with type 1 diabetes increases the risk for DKA by 2-3 times compared to those who did not use cannabis. Researchers speculate that the increased risk for DKA in cannabis users may be due to a number of factors, one of which is delayed gastric emptying (when food takes longer to pass through your stomach) though it’s not clear why.
Cannabis hyperemesis syndrome
Anyone can get cannabis hyperemesis syndrome (CHS), which is recurring nausea, vomiting, and abdominal pain caused by long-term marijuana use.
During his research, Akturk said he started to notice another condition crop up in people with diabetes (especially heavy users) called hyperglycemic ketosis due to cannabis hyperemesis syndrome (HK-CHS).
HK-CHS has similar symptoms to DKA, but they often present out-of-order. In DKA, symptoms usually begin with high blood sugar followed by nausea and vomiting. With HK-CHS, people experience nausea and vomiting (especially in the morning), which causes ketosis, followed by high blood sugar.
The following diagnostic criteria were described by Akturk and his team for diagnosing HK-CHS:
The only way to treat HK-CHS is by stopping marijuana use. People with HK-CHS may need additional short-term treatment like increased fluids and insulin for high blood glucose. The symptoms of HK-CHS can last many days or even months after stopping cannabis use; people often find hot baths or showers provide relief.
Akturk said that HK-CHS is often confused or misdiagnosed as diabetic gastroparesis, another condition that can cause nausea and vomiting.
The bottom line
Marijuana may be beneficial for people with diabetes by helping with blood sugar regulation, weight management, and pain from diabetes-related complications. However, some research finds that cannabis use may be detrimental to blood sugar levels. Further research is needed to fully understand how marijuana affects blood sugar.
If you choose to use cannabis and have diabetes, be sure to closely monitor your blood sugar levels before, during, and after. This is important because potential side effects of cannabis (like gastric emptying) can cause high blood sugar.
Especially for people with type 1 diabetes, it’s a good idea to monitor blood ketone levels as well. Make sure your loved ones know the signs of DKA and HK-CHS in case of an emergency. If you have to go to an emergency department because of severe vomiting and hyperglycemia, be sure to disclose if you use medical or recreational cannabis – this will help ensure healthcare providers make the proper diagnosis and you get the appropriate treatment.
Be honest with your healthcare team about any marijuana use so you can decide together if you should make any adjustments to your eating habits, exercise routine, or medication regimen as a result.
Editor’s note: This article is for educational purposes only. diaTribe does not promote the use of cannabis. diaTribe encourages individuals to follow all state and local laws regarding recreational and medical marijuana use and consult with a medical professional before using cannabis.
Learn more about interactions between diabetes and other substances here: