I love California. This November, Californians will have the opportunity to vote on a measure that would legalize marijuana use and sale in the state. Adults over the age of 21 would be allowed to carry up to an ounce of marijuana, and they would be allowed to cultivate for personal usage up to 25 square feet of cannabis plants. As of April 2009, 56% of Californians surveyed supported the legalization and taxation of pot.
Let me be clear: I like this idea because I think it’s silly to have so much of our criminal justice system tied up with drug charges, and because I giggle at the absurdity of the fact that our state government is essentially saying, “Well, if you can’t beat ‘em…”
In other words, my reasons for liking this proposal, and for liking California, have nothing to do with the drug itself. In fact, pot itself is a big open question for me– namely:
Can a diabetic smoke pot?
I don’t mean “can” here as a verb of possibility or survivability. What I mean is– is it a good idea for a type 1 diabetic to smoke pot? How does marijuana affect blood sugar control and management, in terms of both behavior and biology?
Lacking any personal experience in the matter, I first turn to the internet to answer these questions.
The first thing I note: many other people are wondering the same thing. Rarely does Google pre-fill queries I have about diabetes, but this one Google is all over: “marijuana and diabetes,” “marijuana diabetes type 1,” “marijuana diabetes type 2,” “marijuana diabetes treatment,” and so on.
The results of these queries are full of accounts from people with the personal experience I don’t have. There are apparently many message boards, either diabetes-focused or pot-focused, that have touched on the question of whether it’s OK for diabetics to smoke pot.
The behavioral effects seem widely agreed upon– pot tends to warp the user’s judgement, and tends to bring on “the munchies,” neither of which is particularly good for diabetics. But, notably, neither is insurmountable for diabetics or the non-diabetic pot smoker, and, frankly, neither is all that different for blood glucose control from the effects or being at a party where everyone is eating and the lone diabetic is too busy to pay close attention to her diabetes.
But the biological effects are much more unclear. Personal experience reported on forums here is nearly useless, as most people, especially people under the influence, are poor judges of the exact patterning of biological or metabolic changes. Some people claim pot use lowers blood glucose and HbA1c (see bob1234 here), others claim it raises blood sugars, and no one is impartial. (Unsurprisingly, everyone who identifies as a pot-smoking diabetic in these forums thinks it’s just fiiiiine.)
Medical research, unfortunately, does not prove to be much help either here; there are plenty of papers on the blood glucose control of substance-using diabetics, especially teens, but asking “How well do pot-smokers manage their diabetes?” is very different from asking, “What, independent of behavior and emotion, does pot do in a diabetic?”
So, I conclude: I don’t know if I could or would smoke pot, even if it were legal.
Of course, if marijuana use is legalized in California, there will likely be a sudden increase in the amount of available scientific research on the subject, complete with double-blind tests and molecular analyses of the effects of marijuana on all sorts of people, including diabetics. (Can’t you just see it now? Every grad student in California will suddenly decide, gee, I want to write my thesis on how pot affects my depression/angst/ability to parse 19th century English literature…)
Any type 1 diabetics out there with experience want to weigh in?
*For more on Marijuana and diabetes click here.