The World Health Organization once called diabetes a global epidemic, impacting almost 400 million people worldwide. In the United States, estimates are closer to 30 million people living with Type 1 or Type 2 Diabetes mellitus. And health agencies estimate that approximately 8 million people may have undiagnosed diabetes.
Diabetes is also called a “silent killer” because patients may have the condition and no recognizable symptoms. This is particularly true for Type 2 diabetes. However, without treatment and important lifestyle and dietary changes, diabetes can cause adverse effects that can be life-threatening.
In this article, we’ll review both types of diabetes and how they differ. We will also discuss symptoms and how doctor-supervised cannabis may help patients living with diabetes. And whether some of the side effects of diabetes can qualify you for a medical cannabis card.
Understanding the Two Different Types of Diabetes
Diabetes mellitus refers to a condition where the body cannot produce sufficient insulin to regulate healthy blood sugar levels. Both types of diabetes involve an impairment in the proper functioning of the pancreas and similar health and wellness risks.
There are some differences, however, between Type 1 and Type 2 diabetes. And for patients with the condition, one type involves more frequent and drastic fluctuations in blood glucose levels and immediate side effects.
What is Type 1 Diabetes?
This variant is also known as insulin-dependent or sometimes juvenile diabetes. It is a chronic disease and autoimmune condition. Patients with Type 1 diabetes have a malfunctioning immune system that attacks all insulin-producing cells (beta cells) in the pancreas.
Some patients with Type 1 diabetes cannot produce enough insulin. Others cannot produce any insulin at all. Insulin is a hormone that regulates blood sugar levels by allowing glucose to enter into cells to be used as an energy source; when there is not enough insulin produced, blood sugar levels rise (hyperglycemia), which can cause many health complications. Some side effects of underregulated glucose include heart attack, stroke, blindness, nerve damage, and neuropathy.
People who have Type 1 diabetes have to take daily insulin therapy to live. Very close monitoring of blood sugar levels is also required. Insulin is delivered to the body in the form of injections or automatically as needed by a device called an insulin pump. Diet is essential (low sugar, high fiber, and proteins). Insulin levels must be adjusted, as they can change because of exercise, stress, or bacterial or viral infections.
Type 1 diabetes is less common, with about 5% to 10% of Americans living with the chronic health condition. It is considered hereditary in most cases, and there are no known ways to prevent Type 1 diabetes from developing.
But with guidance from a physician, a healthy lifestyle, dietary choices, and medication compliance, people living with Type 1 diabetes can reduce the risk of health complications.
What is Type 2 Diabetes?
While almost 40 million Americans have been diagnosed with diabetes, about 90% of patients have developed Type 2. About 1 in 10 Americans has diabetes, but Type 2 diabetes most commonly develops in patients over the age of 45 years. It can, however, occur at any age, and if one or more close relatives have diabetes, you may have an increased risk of developing the chronic disease.
Patients living with Type 2 diabetes do not produce enough insulin, or their bodies cannot effectively use the insulin that is produced by the pancreas. Whereas Type 1 diabetes involves an immune system attack against insulin-producing cells, Type 2 diabetes is different. It results from a combination of insulin resistance and insufficient insulin production.
When someone has Type 2 diabetes, the cells become almost immune to the effects of insulin. Because of this, the pancreas then produces more insulin. Over time, this can exhaust the pancreas and impair its ability to produce sufficient quantities of the essential hormone.
Therapy for people with Type 2 diabetes prioritizes insulin control. That means important lifestyle adjustments like low carbohydrate dietary changes, exercise, reduced alcohol, and lower fat foods.
Side Effects of Diabetes
Because increased glucose in the bloodstream causes more plaque to be deposited, causing arterial inflammation, controlling cholesterol is very important. Over time, cholesterol can narrow arteries, increase blood pressure and reduce blood flow to the heart and brain. When this happens, the individual can have a high risk of a heart attack or stroke.
One of the other side-effects of uncontrolled high glucose for people with Type 2 diabetes is nerve pain and damage. Diabetic retinopathy is the loss of vision, sometimes resulting in blindness.
Extremities such as the toes, feet, fingers, and hands may also suffer from nerve damage due to poor blood flow and damage from high blood glucose. This can result in neuropathic pain or uncomfortable numbness and tingling in the extremities.
The combination of reduced blood flow and nerve pain and damage can also contribute to a compromised immune system. All patients with diabetes are more susceptible to infections, which can become life-threatening if not treated.
What are the Risk Factors for Developing Diabetes?
Some risk factors are lifestyle, which can be controlled with essential health changes. However, there are other contributing factors that you may not be able to influence or control that can place you at higher risk of developing Type 2 diabetes.
The risk factors for Type 2 Diabetes include:
- Obesity or excess body weight. Abdominal obesity is considered the highest risk.
- Unhealthy diet. Low fiber and high carbohydrate and processed foods, beverages high in fructose and sugars, or saturated fats may increase the risk of diagnosis.
- Sedentary lifestyle. Not enough exercise every day or long periods of inactivity.
- Family history. If you have one or more close family members with diabetes, you have an increased risk of developing the condition. Patients with a family history of diabetes where first-degree relatives (FH1) have been diagnosed have a 30% to 70% increased risk.
- Ethnicity may also increase risk. Statistically, diagnoses of diabetes are more prevalent in African Americans, the Hispanic community, Indigenous people, and Pacific Islanders.
- Gestational Diabetes. If a mother was diagnosed with gestational diabetes during pregnancy, they have a higher risk of being diagnosed with Type 2 Diabetes later in life. Some studies suggest as many as 50% of women may develop Type 2 Diabetes after a gestational diagnosis earlier in life.
- Polycystic Ovary Syndrom (PCOS). Women diagnosed with PCOS have a higher risk of developing Type 2 Diabetes.
The factors contributing to a higher risk of developing Type 1 Diabetes are somewhat different. Those risk factors include:
- Autoimmune Diseases: Some autoimmune conditions like Hashimoto’s or Addison’s disease can increase the risk of developing Type 1 Diabetes.
- Age. Children and adolescents most commonly develop Type 1 Diabetes. However, the disease can develop at any age.
- Heredity. Individuals with a family history of Type 1 Diabetes are likelier to develop the condition.
If you have one or more of the risk factors that contribute to diabetes, you can take steps to monitor your health more closely. Ensure you get an A1C (blood glucose) test annually, and start developing a healthier lifestyle, to help reduce your risks.
Is Diabetes a Qualifying Health Condition for Medical Marijuana?
Diabetes as a specific diagnosis is not typically found as a qualifying health condition for state-legalized medical cannabis. However, some states have exceptions or broadly defined categories where someone with a diagnosis of diabetes may qualify.
For example, neuropathic pain (or peripheral neuropathy) caused by diabetes may be eligible for chronic pain or neurological disorders diagnosis. For some patients, diabetes may also cause gastrointestinal infections that cause weight loss. That may qualify in states where cachexia is an accepted diagnosis for medical marijuana.
Can I Get a Medical Marijuana Card for Symptoms?
While diabetes is not listed as a qualifying health condition, it is a chronic disease, meaning many associated symptoms are long-term or permanent for the patient. Under most circumstances, these conditions may be accepted by the recommending marijuana doctor.
Patients who wish to qualify using a symptom should have documentation from their primary care provider. Often patients have suffered debilitating symptoms for years and tried different therapies to moderate their pain. You can present that information at your medical cannabis health evaluation.
Physicians are compassionate when it comes to helping patients. At DocMJ, our doctors support your “right to try” alternative treatment when other therapies have been ineffective. It is also possible to request special consideration in writing directly to the state medical cannabis program.
Cannabis and its Effect on Diabetes
There is growing evidence that consuming marijuana may offer some benefits to patients living with diabetes. Another reason why diabetes as a diagnosis does not appear as a qualifying health condition is that most of the symptoms consistent with Diabetes fall under other chronic diseases and symptoms.
Other studies suggest that medical marijuana that has high levels of cannabidiol (CBD) can be very effective at moderating blood glucose levels. Based on the research, CBD may help improve insulin sensitivity at the cellular level. But CBD alone is not as effective without THC. This is why some studies suggest low-THC medical marijuana with high CBD content.
Help With Cravings and Managing Weight
Managing body weight is particularly important for patients with diabetes. The more volume you carry on your frame, the more insulin your body needs. When the pancreas cannot provide the right amount of insulin, creating more demand for the vital hormone can cause serious problems.
Abdominal Fat is a Big Problem When You Have Diabetes
The weight that accumulates around the midriff or abdominal area is particularly bad for patients with diabetes. There are five reasons why abdominal fat is even more harmful to people living with Type 2 Diabetes:
1. Insulin Resistance
Abdominal fat releases many different substances, and it is metabolically active. That’s right; those fat cells constantly do things (not just sit there). And many of the activities of adipose and normal fat cells can exacerbate diabetes and make it worse, mainly by blocking insulin signals, which can accelerate insulin resistance and promote high blood sugar levels.
2. Increased Inflammation (Cytokines)
Abdominal fat releases cytokines, including TNF-alpha and IL-6, which can cause chronic inflammation. High inflammation levels can accelerate insulin resistance and make glucose control more difficult.
3. Dyslipidemia (Increased Blood Lipids)
Excess fat in the abdominal area can increase triglyceride levels (bad fats) and decrease high-density lipoprotein (HDL) cholesterol (good fats) in the body. Triglycerides are responsible for clogging up arteries and can increase risk factors for heart attack or stroke.
4. Increased Adipokines
When you have a lot of abdominal fat, it releases something called adipokines (adiponectin and resistin), messing with the natural balance. When adiponectin levels are low, it helps your body combat inflammation and insulin sensitivity. When those adipokine levels are high, it interferes with insulin sensitivity and functioning.
5. Slower Metabolism
People with large abdominal fat volume have slower metabolic functioning. That impairs the body’s ability to burn fat and regulate blood pressure. It can also increase the risk of blood clotting, aneurysms, heart attack, and stroke by throwing glycemic and lipid parameters out of order.
Does Cannabis Conflict With Diabetes Medications?
There are a few considerations patients with diabetes should discuss with their primary care provider and cannabis healthcare specialist.
The following medications may conflict with medical cannabis:
- Sulfonylureas (glipizide, glyburide, and glimepiride). Cannabis may lead to a higher risk of low blood sugar (hypoglycemia).
- Thiazolidinediones (pioglitazone and rosiglitazone) medications help increase insulin sensitivity and lower blood sugar levels. They can be contraindicated, depending on other types of prescription medications taken.
- Insulin sensitivity may be improved by using cannabis, according to some studies, which can lower the requirement for supplemented insulin (oral or injected). Research results are inconsistent, so patients should regularly consult a physician and monitor blood sugar levels to manage appropriate insulin doses.
- Oral antidiabetic medications, including metformin, dipeptidyl peptidase-4 (DPP-4), and sodium-glucose cotransporter-2 (SGLT-2), may also be contraindicated for some patients.
Talk to your cannabis healthcare provider (doctor) to explore whether medical marijuana is safe for diabetic symptom management.
Aaron Bloom, an experienced healthcare attorney, serves as the CEO of DocMJ and Medwell Health and Wellness Centers, where he has overseen the organizations’ mission and growth since 2016. In addition to his leadership roles, Aaron serves on the Board of Directors for Waterfall Bank, bringing his expertise in healthcare, compliance, and strategic growth to the financial services sector.
Aaron’s passion for improving patients’ lives stems from more than 20 years of owning, operating, and representing traditional healthcare organizations. Throughout his career, he has remained committed to finding better ways to relieve suffering and expand access to innovative, patient-centered care. As CEO, Aaron works each day to help patients achieve better health and wellness through the therapeutic benefits of medical cannabis and other evidence-based alternative medicines.