THC and insulin resistance (diabetes)

[Alex_Dubinsky]

Does habitual use of marijuana cause insulin resistance?

There’s been a lot of research showing that endocannabinoids are a vital part of the glucose cycle, and that smoking marijuana causes insulin to spike. Many believe the ‘munchies’ are a direct result of the high insulin. But over time, wouldn’t this rollercoaster cause the body to develop insulin resistance? For example, one of the big signs that you’re a pothead is that you stop getting the munchies. Disturbing the glucose cycle is something very bad, potentially causing all sorts of physiological and psychological problems.

[CC]

I’m interested in your original literature. Citations? I’m also interested in the definition of “pothead.” I have been - no, make that a friend of mine has been - smoking pot occasionally for about 40 years. He still gets the munchies. Does this mean he is* not * a pothead? I’ll stay tuned to this thread - if I can concentrate.

[PuddingCat]

I would also be interested. I have a close acquaintance who is a regular cannabis user and later developed type II. I haven’t yet seen anything which demonstrates a convincing (or even plausible) link.

tim

[Si_Amigo]

My friends are interested in cites as well. Never heard of this theory of the munchies causing diabetes.

[susan]

I can tell you that from the diabetes education end, patients are warned about the positive and negative aspects of alcohol and amphetamine use on blood sugar, but I haven’t seen anything for diabetics on marijuana use.

[Qadgop_the_Mercotan]

Multiple studies have failed to show any link between marijuana use and hypoglycemia, or insulin metabolism alterations, to my knowledge.

Case in point:

Am J Psychiatry 1976; 133:220-224
Copyright © 1976 by American Psychiatric Association

The effect of marijuana on carbohydrate metabolism
MA Permutt, DW Goodwin, R Schwin and SY Hill

The authors observed the effect of marijuana on carbohydrate metabolism in fed and fasting states in chronic marijuana users. They found no hypoglycemia in 7 patients who were given marijuana after fasting for 24-72 hours. They also found no significant difference in carbohydrate tolerance and no hypoglycemia during an oral glucose tolerance test in 10 patients who smoked placebo or marijuana on alternate days. They conclude that marijuana has no effect on carbohydrate metabolism in the fed or the fasted state in well-nourished chronic marijuana users

If you have any credible cites for your assertion, I’d love to see them.

[Alex_Dubinsky]

Hey… I wasn’t asserting, I was asking.

Here’s an example of the molecular biology findings that point to a connection. Abstract from The endocannabinoid system, Obesity, and insulin resistance, published in 2008:

Prompted by findings in the Rimonabant in Obesity trials, metabolic endocannabinoid research was started about 3 years ago. Although research is still in its infancy, the first findings have already helped us begin to understand the metabolic improvements engendered by cannabinoid-1 (CB1) blockade. Lipogenic effects of CB1 receptor (CB1-R) signaling in liver and adipose tissue may contribute to regional adipose tissue expansion and insulin resistance in the fatty liver. The association of circulating 2-arachidonoylglycerol levels with decreased insulin sensitivity strongly suggests a need to explore the role of CB1-R signaling for insulin sensitivity in skeletal muscle, liver, and adipose tissue. Clinical and experimental studies have suggested a specific role for the regulation of adiponectin secretion from adipocytes by endocannabinoids. Together, these findings open a new perspective on endocannabinoids as regulators of metabolism.

Another paper researching this general area of endocannabinoid-glucose interaction is Role of cannabinoid CB2 receptors in glucose homeostasis in rats

Here we show that the activation of cannabinoid CB2 receptors improved glucose tolerance after a glucose load. Blockade of cannabinoid CB2 receptors counteracted this effect, leading to glucose intolerance. Since blockade of cannabinoid CB1 receptors mimics the actions of cannabinoid CB2 receptor agonists, we propose that the endocannabinoid system modulates glucose homeostasis through the coordinated actions of cannabinoid CB1 and CB2 receptors. We also describe the presence of both cannabinoid CB1 and CB2 receptor immunoreactivity in rat pancreatic β- and non-β-cells, adding the endocrine pancreas to adipose tissue and the liver as potential sites for endocannabinoid regulation of glucose homeostasis.

However, it does seem that direct testing of weed’s effect on blood sugar is very murky. There’s even a Straight Dope piece about this topic, but from 30 years ago (when apparently vipers smoked reefers). What’s not clear to me is if the research that’s been done only looked at blood sugar, or monitored other signs as well.

The reason I ask is I’ve been experiencing hypoglycemic symptoms. Headaches, mood/personality changes, and confusion, which (mostly) go away when I eat. And all this correlates with the history of my habits. My blood sugar is normal however. One test did turn up a couple points above normal.

[KarlGauss]

There’s a lot already known (but much more still unknown) on the relationship between the endocannabanoid system and obesity, appetite control, energy balance, etc.
Here are two representative reviews: review #1 and review #2. (Just to whet your appetite, blockade of one of the cannabanoid receptors leads to improved glucose control in type II diabetes).

However, in terms of marijuana itself, as opposed to cannabanoids, just as Qad said, there’s no independent link* with diabetes, insulin, hyperglycemia, etc.

(*sure, if you smoke pot and sit around, satisfy your munchies, and listen to music all day (and night), you’ll probably develop insulin resistance and maybe even frank diabetes, but that would obviously be an indirect effect of the weed.)

[Alex_Dubinsky]

no leads?

[CC]

@KarlGauss

…
(*sure, if you smoke pot and sit around, satisfy your munchies, and listen to music all day (and night), you’ll probably develop insulin resistance and maybe even frank diabetes, but that would obviously be an indirect effect of the weed.)

I’m thinking that the link between listening to music (bolding mine) and insulin resistance is pretty tenuous. While there are many songs that refer to dextrose, glucose, and/or sucrose (Sugar, Candy, and Sweet Home, Alabama come to mind) I’m doubtful that factor is significant in the development of diabetes, frank or otherwise.

[Alex_Dubinsky]

btw. In the OP I mentioned loss of appetite as a symptom of THC fucking up metabolism. Actually, I said you stop getting the munchies, but it’s deeper than that. Here’s what I was talking about:

Quit marijuana use, loss of appetite?
by MichaelD, Nov 07, 2005 12:00AM
This is a serious question. I’ve been smoking marijuana regularly (around 3-4times a week) for around 6 months. After much thought, I’ve decided to quit and have stopped completely. I feel okay, and don’t miss it at all. I’m posting because I just can’t seem to eat. I’ve had this problem for about a month now (also around the same time I quit) and I’m wondering if it could be linked to the marijuana use? I feel hungry, but when I sit down and start eating I get nauseous and have to literally hold myself from vomiting. If you suspect that this is the cause, what can I do to start eating again?

Thanks for your time,
Michael
by Lynn85, Jan 28, 2006 12:00AM
female, 21 years old. I have the same problem. I was smoking marijuana everyday, 1-3 times a day for about 6 months. I haven’t smoked in 2 weeks and i cannot swollow food without gagging. i now gag even when i’m chewing food and it hasn’t even touched my throat. i still had this problem even when i smoked marijuana. i’m 5’7" 104lbs… i know, i’m underweight.
by Ashton11, Aug 25, 2007 12:37PM
I’m 17 and have been smoking marijuana for the past year and a half. I need it to eat. Without it i have no appetite and If I try to eat i will vomit. I normally weigh 118, but am now down to 104. Unfortunetly what i have been doing is just giving in and smoking so that I can get some sort of appetite or hopefully “the munchies”. This is an endless cycle. I can’t smoke weed forever, but I have to eat. what do I do? I’m really worried please help.
by TLD1, Sep 07, 2007 06:34PM
Yeah, weed is… I’ve smoked a disgusting amount, most likely more than any of you think possible. I still have the occasional toke. I’m used to rolling out of bed and puffing away. It got to the point where i needed to smoke to eat. I still almost do but i’ve stopped smoking pot as of late and my appetite did go. My number one recomendation for getting your activity is to take up physical activity.
by dysfunctionaltrip, Mar 04, 2008 08:42AM
Ive been a marijuana smoker for years. a few years back i had to quit…personally reasons. the first month or two were horrible for me. i had trouble eating and sleeping. i would be up til 5-6 am trying to go to sleep. marijuana has chemicals in it that alter other chemicals in your body. once your body is rid of the drug and toxin, it will return to normal. its a consquence of putting any substance in your body for a extended period of time.