Can a Diabetic Smoke Marijuana?

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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.

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Comments (27)

  1. MRJ at

    Thanks, this is an important topic, too little covered, as you say. My two cents follow. The question in your title reads a lot like “Can a diabetic drink alcohol?” Many people suffer under the illusion that it is forbidden for diabetics to drink alcohol. Every doctor I have ever talked to has said that it’s OK, only that beer and wine RAISE bg levels; distilled drinks may LOWER bg levels. One has to take that into consideration, as well as the fact that alcohol can impair judgment, etc. I don’t see why the exact same reasoning would not apply to marijuana. And this is in fact what every doctor I have talked to about marijuana says. (Endocrinologists also happen to be interested in the mechanism by which pot smoking causes hunger; one hypothesis is that it increases insulin production.) In general, I think one should avoid framing issues as “Can a diabetic do X” where X is something like “putting white sugar in tea” or “eating eggs” or “drinking alcohol” or “smoking marijuana”. The question is: what risks associated with this activity are uniquely worse for diabetics, and how bad are they? It turns out that smoking tobacco is deadly for diabetics (and for everyone else), and so that is surely too great a risk. But NONE of the bad things about tobacco apply to marijuana, and there is nothing uniquely bad about marijuana  for diabetics. I will not here get into the myriad possible health benefits of marijuana for diabetics, such as the neuroprotective effects of cannibidiol, or the possible pain therapies for diabetic neuropathy. But either there is no yes/no answer to the question, the answer is: “yes, a diabetic can smoke pot so long as she takes into consideration that…”

  2. MRJ-  interesting comment… in particular the hypothesis that marijuana increases insulin production.  Also, I was under the impression that wine doesn’t raise BG the way beer does.

  3. Allison at

    I don’t have personal experience in it, but I would caution that there’s already an issue going on with people needing organ transplants who are turned down because of marijuana use (even medical marijuana). 

    Since diabetes is the #1 cause of kidney failure (which leads to a need for a kidney transplant), that would be a good reason to avoid the use of marijuana.   

  4. MRJ at

    Allison: could you say more about “an issue going on with people needing organ transplants who are turned down because of marijuana use– even medical marijuana”. What is the issue?
    Also, I disagree with the argument in your final paragraph. All that follows from diabetes being the #1 cause of kidney failure is that diabetics who are suffering from diabetic kidney disease (a small fraction of those who suffer from diabetes) and who are candidates for kidney transplants (a small fraction of those who suffer from diabetic kidney disease) should consider not smoking marijuana if they also have whatever issue you are talking about that complicates marijuana users from getting a kidney transplant.

  5. MRJ at

    Jessica: I was simply referring to the fact that wine has carbohydrate, and so will raise bg on that score. I think you might be right that on average wine does so less than beer. A glass of red wine has about 5 grams carbohydrate; a Guinness has about 10 grams (all these vary depending on a variety of factors).

  6. MRJ at

    Allison: I was simply referring to the fact that wine has carbohydrate, and so can be expected to increase bg on that score. You are probably right about wine doing so less than beer.On average a glass of red wine has just over 5 grams carbohydrate; and Guinness just over 10 grams, and so diabetics who have one of these will have to adjust insulin dosages accordingly. Pot smoking does not contain carbohydrate, and I do not believe (based on personal experience) that it has a direct affect on raising or lowering bg. Here is a link to an article including the theory that marijuana reduces bg: http://www3.interscience.wiley.com/journal/119693693/abstract?CRETRY=1&SRETRY=0 But here is a link to a study claiming there is no effect: ajp.psychiatryonline.org/cgi/reprint/133/2/220.pdf
     

  7. J. Spicoli at

    Dude, of course a diabetic can smoke up – everyone can.

  8. Karmel Allison
    Karmel Allison at

    Sorry, MRJ, but I’m with Allison on this one– @Allison, that is a very good point, and not one I had thought of. I don’t intend to ever reach the point where I need a kidney transplant, but it is important to recognize that for any organ transplant or life-saving operation with contended resources, I already have ten strikes against me because I’m a diabetic. Why bother performing a costly operation if statistically I have an x% chance of dying prematurely anyways because of poorly maintained diabetes? At this point, a reasonable argument could be made that I have very well-maintained diabetes, and therefore I should be an eligible patient. However, if I’m a diabetic and I am found to smoke marijuana… I wouldn’t want to be the doctor making that call. All theoretical, of course, but worth considering nonetheless.

  9. Allison at

    My information regarding the leading causes of kidney failure comes from the American Diabetes Association website, which says:
    “Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2005.”

    See http://www.diabetes.org/diabetes-basics/diabetes-statistics/

    (Hypertension is the second leading cause, and of course that’s another common diabetic complication).

    The issue about smoking marijuana, combined w/ diabetes and transplants, is this:
    “Hospital transplant programs, wanting to ensure the best possible outcome for each transplant and to make optimum use of the limited number of organs available, have strict standards about drug use and smoking in determining who is eligible for a transplant list.”

    (From this story:  http://articles.latimes.com/2008/may/19/nation/na-transplant19

    I received a kidney and pancreas in 2005; transplant programs are quite strict about a lot of things.  For example, if I had skipped dialysis sessions, I would have been removed from the active transplant waiting list, which makes sense when you have over 108,000 people currently waiting for some kind of organ.  Why give it to someone who won’t go to their dialysis sessions, and why risk smoking MJ, which might or might not interfere with the transplanted organ or interact very badly w/ the anti-rejection medication?  Sorry, I can’t sign up to be the guinea pig for that medical study.   

  10. Lockerzz at

    Im 15 and im diabetic. I like to have a nice blaze up on the weekend with my mates, i occasionally drink aswell, I had it all under control but recently the munchies have been hitting me badly and it raises my blood sugars to around 21.0-23.0. Any suggestions on how I can keep better control of my blood sugar and still smoke weed which I enjoy? thanks

  11. Karmel Allison
    Karmel Allison at

    Hi Lockerzz,
     
    I don’t suppose, “Hey, maybe you shouldn’t do that,” is the answer you’re looking for? ;)
     
    I do not have any personal experience with managing blood sugar when smoking pot– but I do unfortunately have personal experience with out of control blood sugars during my teen years. So I know first hand– it’s dangerous, and it does matter; I have cataracts from poor control for a few years. Please be careful, especially when smoking and drinking. Is there any doctor– primary care, endocrinologist, nutritionist even– who you would feel comfortable speaking to? Who would keep things confidential? If so, I would suggest asking him or her for best-practice advice. If not, maybe enlisting a responsible friend to be a “designated driver” for you diabetes during the occasional excursion?
     
    Again, I am only guessing here; if anyone else has personal experience, please, do add your two cents in these comments. @MRJ? Thoughts?

  12. Sissy at

    My queston is…. is marijuana safe to smoke with diabetes medications  metformin,lisinopril,lovastatin? 

  13. GunnyD at

    @Lockerzz,

    Even if you do not have type 1 or 2 diabetes you should not use marijuana.  The human brain finishes developing for the most part between 18-21.  At your age you can cause irreversible brain damage.  Not so much as to be quantified but it will leave you if let’s say have a genius IQ, it will leave you at a “normal” range.

    @Sissy,

    The answer is yes.  You will have every healthcare professional tell you that it is dangerous.  That is a patent lie, and this is coming from an experienced nurse. Marijuana is safer to combine with the medications you listed than taking 2 aspirin with them.

  14. tracey at

    Ok this goes out to lockerzz, if you’re having a problem with munchies take a few units of insulin extra before u blaze and drink a lot of water, the water helps lower the blood glucose level and stops cotton-mouth.

  15. Tom at

    Im 16 and have had type 1 since about 8, having smoked it a few times i can say from personal experice that it doesnt directly or noticably affect bg, but ovbiously the munchies do, but to avoid that, i just take insulin either before i blaze or when im about to eat. Basically the same decision for those who arent diabetic.

  16. dee at

    It helps me not throw up.

  17. rendrag at

    According to this article in the British Medical Journal. 

    http://bmjopen.bmj.com/content/2/1/e000494.full 

    People who or who have smoked cannabis have significantly lower incidence  
    Diabetes.

    They also had significantly lower levels of C-reactive Protein, which also helps with heart disease.

    Try googling “cannabis protection against” and spend a few hours reading the scientific literature.

    Then consider that this remarkable non-toxic plant could be grown for free in peoples backyards while saving the public billions in healthcare and law enforcement.

    Those billions explain why cannabis remains illegal.

  18. shane_sk821@hotmail.com at

    Hey there, I am 23 years old and a full-time physics student and I have had Type 1, diabetes for 13 years…. I smoke pot anywhere from 2 times – 6 times a day. My hemoglobinA1-c is around 6.2 and I get blood work done every 3 months. I have an endocrinologist who really helps me if I ever do encounter issues with my type 1 diabetes. It all comes down to keeping aware that YOU ARE STILL DIABETIC, even when you smoke pot or drink…. I personally DO NOT DRINK AT ALL… it is the devil for a diabetic!!! I live in Victoria B.C in Canada and our legal dispensaries actually permit use of marijuana for diabetes. I do not have a license personally but am applicable to get one. Other than that I think it is totally an ok choice seeing as diabetics shouldn’t drink, but maybe want to feel some state of euphoria…. I say pot is a good choice as long as you are good at managing your diabetes, but if you cannot I would not recommend it!!!!! Cheers, I hope that helps!!!!

  19. Kyle at

    i’m 15 and I’ve had diabetes for 6 years now. i smoke marijuana weekly, and i haven’t found anything different with my bg levels at all. the only precaution i do is give insulin before i smoke because i almost undoubtedly will eat something. it’s been about 4 months now since i started. i feel that it’s safe.

  20. Jack at

    I’m 18 years old and a freshman in college. I’ve been diabetic for about 8 years and have been smoking weed regularly for about a year. No, I am not the TV generated “pot head” that everyone associates weed with. I have good grades and take very good care of my diabetes. (A1c is 7.1) I can honestly say I have never noticed that my diabetes is affected by weed, nor has my endrocronologist. Since starting smoking regularly, my A1c has not budged, and I’m as happy as ever. Smoking cigarettes, on the other hand, is a killer for diabetics. Therefore, I refuse to smoke any sort of tobacco. Weed is a beautiful thing for those who understand their bodies, and have the self control to not try serious drugs. Just make diabetes your first priority.

  21. Chronic Pain at

    I will say this much, After living with Chronic pain for a huge part of my life, if med marijuana was used instead of the pharmacuticals that I was given by my doctors, I WOULD NOT HAVE DIABETES TYPE 1 NOW! 

    For people like me that have allergic reactions to many pharacuticals medical marijuana would have been the best way to go, and I would still have my health instead now I’m on 7 shots a day to stay alive, did I get a settlement? Am I helped with the inconvience and lack of quality of life and the expense? absolutly not, I lost use of a major organ and all I got was a shrug from the doctors.

    Unfortanatly this reader is studing poeple that 1. either use way too much MM for thier condition, 2. or are so far gone from chronic pain that they have no choice but to be stoned.

    It is a misinformed opinion that MM users have to be stoned to get some relief from pain, I don’t like nor want to be stoned, drunk or impared in any way and there are hundreds of thousands that feel the same way, what I have found is that most MM patients are way overdosing themselves and if they raise the CBD in thier meds or supplement with hemp seed oil which is high in CBD, than the “stoned” “buzz” effects from the THC deminishs, THC kills pain, CBD kills spasms and inflamation, raised CBD protects the brain.     

    People that abuse medication will abuse anything that is thier sickness, Type 1 Dibetics are very aware 24/7 that death is always at the door. 

    Pharmacuticals raise blood sugar levels, not being able to get exercise because of pain raises blood sugar, getting hopless because one can’t get anything done causes deep depression, in which than the med’s for depression raises blood sugar, as does stress,   which in turn the diabetic looses appitite.

    MM increases the ability that pain releaving opiate have to reduce pain therefore one only needs minute dose of opiate in their systerm, which in turn reduces addiction and body damage and expence.  

    I am so sick and tired of people assuming that   MM patients are to be high or stoned or even buzzed if they are to use MM for thier choice on pain management, and claiming that smoking it is the only way to take it.

    And at this rate, I’m almost glad now that the USA phamacutical regulations are killing me one organ at a time because they already have taken away my rights to have any quality of life by making the one thing that could save my life and even put me back into being productive illegal, I really don’t want a shortened life but if you can barely move from chronic pain there is no life.

    I’m tired of living in chronic pain and being usless because of stupid laws made for a few privledged spoiled power hungry people, and unfortunatly too poor to hire someone to move me to a legal state and too poor and unconnected enough to use MM, I wouldn’t have the money to hire attorny, pay fees and get my get out jail card, and clear my name from bad reputaion and criminal records, where the politicians make laws that they know they can get out of because of their contacts and influense if they ever needed MM. That isn’t the case with the average Pain sufferer.

  22. Shaun at

    I believe we can smoke small amounts without too much risk, well I hope, anyway I do and noticed its best after meals and helps slow down the release of sugars naturally I think. it can raise BPp though and create blood clots in kidneys.

  23. Andrew at

    I’m 32 years old. I have been a type 1 diabetic for 18 years, type 1.  I became a regular cannabis user for the last year.  My observations on my body:
    1)  Cannabis itself does not lower my blood sugar. I experimented with this using a continuous glucose monitor.
    2)  I have found the best way to control my blood sugar while being on the effects of marijuana is by using sativa-dominant strains. Sativas give me the energetic head high as opposed to the indica dominant strains which will make you lazy and give you the munchies. I get active from sativas which makes my blood sugar go down, but usually I monitor often and make sure to snack.  By the way, monitor often!! Set reminders on your phone if you need to!
    3)  Have low carb snacks if you’re going to snack and get the munchies. Make some deviled eggs before you get baked. Have some lettuce wraps.  The low carb snacks should have minimum effect on your blood sugar.
    4)  I prefer vaporizing over smoking for health reasons. Smoking marijuana, while safer than smoking cigarettes, can cause health problems.

    The important thing though is know thy body.  These are my observations on my body. The best way to know thy body is to monitor often.  

  24. MMDiabetic at

    I am 47 yr old female that never smoked pot before, but after much research and self reflection plus pros/cons, I went and got my MM card 6 days ago.  I have chronic pain and spasms in my back due to many back fusions, and I am also a Diabetic. I am far from a pro about this topic, but I am doing a self test on MM and my diabetes. I know the two main strains I’ve been smoking, are more of a body buzz, I don’t really get the munchies, my head isn’t clouded. The strains I use are Indica, less thc and more cbd. I smoke a few hits a few hours before i go to bed, and I have never slept better, wake up alert and refreshed, and my bg numbers are already lowering.  I asked advice from my primary physician, and she said she couldn’t condone it but she did admit there are many benefits. 

    The first day I smoked, I felt guilty and hypocritical. Many mixed feelings and emotions.. But now,less than a week, I don’t have the stomach issues I was before smoking, hardly any pain when I wake up, spasms have decreased and I can’t imagine my life without it now. I just had my A1C done last week and I had come down some before stating to smoke, I’m anxious now to go back in 3 months to have my blood drawn again, and see what type of results I get. Never in my life did I think I would start smoking weed at 47 lol.. but so much has changed since, less depression, I’m just happier period. Here is an article I found, that might help with some of the questions here.. hope it helps some.   http://www.cnn.com/2013/05/23/health/time-marijuana-diabetes/index.html

  25. Joe at

    Hi my name is Joe.I have Type2 diabetes I’v had it for 10 years now.It’s always been pourly controlled.I went to a diabetes clinic to get help and befor i new it i was taking 5 injections of insolen a day.I started to gain wheght and my bloodshugers where still out of wack.I was fed up and started a on carb diet.I eat plenty of food and I lost 20 pounds in 2 mounths I don’t take any insolen any more.what I’m try to say is you don’t need anything els but willpower.

  26. gretchen at

    Seriously use common sense…..what good can come from smoking ANYTHING?
    Diabetics have a much higher risk of high blood pressure, heart disease and neuropathy. Why risk making it worse?
    Please read the affects to your lungs and body from smoking marijuana.
    http://adai.uw.edu/marijuana/factsheets/respiratoryeffects.htm

    The air in your home can be polluted from burning wax candles!
    Or from not using your exhaust fan in the kitchen!

  27. raymond scott rockwell at

    very good article Karmel.
    marijuana requires alot more medical research especially from an endocrinological pov. maybe soon we will see some credible research. i also agree its basically useless for people under the influence to weigh in with their experiences as everybodys diabetic body is in slightly different shape and well they aint no scientific studies.
    BUT some of that information gives us some insight.
    I am 30yrs old male, have been a type 1 diabetic for 23 yrs and i have habitually smoked marijuana for the past 11 yrs. my hemoglobin is 8.0 and has remained steady for 2 yrs. i started exercising to get my numbers and weight down. being a diabetic is a challenge in itself but when you factor in complications and and other health conditions that require medication it turns into a nightmare.
    i dont encourage young people to smoke until they are old and wise enough to understand the risk. its the same as alcohol. moderation.period.
    i have had zero emergencies and have zero complications except a mild degree of depression.

    i speak openly with my endocrinologist about smoking marijuana and i engourage any diabetic looking into this topic to do the same.
    marijuana helps ME gear down at the end of a stressful day and cope with my diabetes one day at a time :)

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