Cannabis for Diabetes Prevention? A 1 + 5-Point Information Leaflet to Read Before Smoking Your First Medicinal Reefer

Weedy discoveries: Diabetes protection or just another addiction?
"Good news everyone! Smoking weed is going to solve all your problems." I guess, most of you will already know that, after all the results from a recent study that comes out of the leave no question: Cannabis is the answer to why we get fat... or rather, not smoking it is the reason we are becoming fatter and fatter, year after year. How the scientists know? Well, they have the cunning of the average epidemiologist who knows very well how to get publicity. And as you can see, they really know what they are doing - why else would something that's about as diametrically opposed to physical culture like smoking weed make the headlines on the SuppVersity?

Let the statistical shenanigan begin!

When you are pro Marijuana you got the support of the majority of the US citizens. Not only has smoking weed been legalized (for medical purposes, of course ;-) in 19 states and the District of Columbia following California's lean in 1996, according to a 2010 ABC poll, "81% of Americans favored medical marijuana use and its decriminalization for this purpose." In fact, "[...t]hese citizens argue that marijuana should be  regulated, sold, and taxed in a manner similar to tobacco and alcohol products." Studies saying that "cannabis is good for you" and the subtle message of "we should all smoke some weed from time to time" (Alpert. 2013) do thus fall on fertile grounds - not just in the outskirts of Hollywood.
I guess that was about enough sarcasm for the day, so let's get to the facts, or rather statistics the scientists derived from a re-analysis of the data from theh National Health and Nutrition Survey between 2005 and 2010. Penner et al. studied data from 4657 patients, of whom 579 were current users of cannabis, 1975  used cannabis in the past, but were now - according to what they told the scientists - "clean" and 2013 bores who had never inhaled or ingested marijuana. The researchers measured the patients fasting insulin and glucose levels and tested their subjects insulin resistance and what they found made the headlines:
Figure 1:Adjusted mean/percent differences in measures of glucose metabolism & BMI/WC according to marijuana use among participants from the national health and nutrition examination survey, 2005 to 2010(Penner. 2013)
Fasting insulin levels were reduced in current cannabis users but not in former or never users. Furthermore, the waist circumference of the users was lower, the high density lipoprotein cholesterol (HDL) levels were higher and the insulin sensitivity was slightly improved.

As Joseph S. Alpert, Professor of Medicine University of Arizona College of Medicine in Tucson and the Editor-in-Chief of The American Journal of Medicine, obviously a highly influential man who says about himself that he was "pleased" (his own words) to finally see the little we we know about cannabis from folktales and limited clinical observation, points out in his editorial (still ahead of print), "these are indeed remarkable observations that are supported [...] by basic science experiments that came to similar conclusions" (Alpert. 2013)

But Alpert is already thinking one step further. Well-versed as he obviously must be how the pharma industry functions, he is already foreseeing a great future for THC-based drugs, which
"will be commonly prescribed in the future for patients with diabetes or metabolic syndrome
alongside antidiabetic oral agents or insulin for improved management of this chronic illness" (
Now at first this may sound hilarious, but after reading the rest of the article you may well realize that the synthesize of pure or slightly modified spin-offs of "regular" THC could in fact turn out to be a viable and not that side-effect ridden tool in the battle against the obesity epidemic. 

Even if all that is true, there are still a couple of strings attached...

Now that the good news are delivered let's come to the not so good and actually not so new stuff about smoking weed:
  • Marijuana makes you dumb - The evidence for the detrimental effects of chronic cannabis consumption on cognition is overwhelming, particularly in younger weed-headz. Examples?
    "Marijuana users demonstrated poorer verbal learning (p<.01), verbal working memory (p<.05), and attention accuracy (p<.01) compared to controls. Improvements in users were seen on word list learning after 2weeks of abstinence and on verbal working memory after 3weeks. While attention processing speed was similar between groups, attention accuracy remained deficient in users throughout the 3-week abstinence period." (Hanson. 2010)
    In adolescents the cognitive impairments appear to be particularly pronounced and last for at least 6 weeks (Schweinsburg. 2008) The longer the chronic exposure to cannabis, the more severe the changes will become (Meier. 2012)
  • Cannabis increases the incidence of psychotic episodes - Obviously psychotic episodes are part of the kick, users expect from cannabis consumption. I am yet not sure if the following items with the highest frequencies of occurrence in a 2007 study (frequency in brackets), i.e.
    "Items with highest frequencies were unusual thought content (100%), excitement (75%), grandiosity (75%), hallucinatory behavior (70%) and uncooperativeness (65%). The least common symptoms were anxiety (5%), guilt feeling (5%), depressive mood (10%), motor retardation (10%) and blunted affect (30%). Nine subjects (45%) presented with cognitive dysfunction " (Kulhalli. 2007)
    ... is something anyone looking to improve his / her glucose metabolism would be happy about - what about you? And what about the voices you are hearing already (cf. Ruiz-Veguilla. 2013)
  • If you are deciding to smoke weed, you better make sure avoid at least all the other anti-androgens on the SuppVersity exclusive "Natural Hormone Optimization Cheat Sheet" Otherwise you may well be in trouble soon. What are you waiting for - go learn them by heart your fertility and sexual satisfaction will depend on it!
    Smoking weed will mess with your endocrine health - THC dose-dependently reduces testosterone levels (-57% in heavy users; Kolodney. 1974)
    "Data from human and nonhuman species converge on the ephemeral nature of THC-induced testosterone decline."  (Gorzolka. 2010)
    From rodent studies we also know that the consumption of low levels of marijuana lead to shrinkage of tubular diameter and detrimental changes in seminiferous epithelium of testis with resulting lowered serum testosterone and pituitary gonadotropins (follicular stimulating [FSH] and luteinizing hormones [LH]) levels (Mandal. 2010). It also reduces sperm count and induces infertility (Banerjee. 2011)
  • Cannabis causes endothelial dysfunction and a lame dick- And as if that was not already enough it can also lead to anorgasmia, which is - as you have probably already guessed - the inability to achieve an orgasm irrespective of your erectile function, by the way  (Saso. 2002; Aversa. 2008; Shamloul. 2011)
  • Learn more about other factors involved in the development of gynecomastia and how to battle it.
    Marijuana will give you breast cancer, gyno and germ cell / testicular tumors  -The growth promoting effects of cannabis are mediated by THC directly at a cellular level via COX-2 (Dardick. 1993; Takeda. 2009).

    In men cannabis use is associated with the development of gynecomastia (Harmon. 1972). The mechanisms are not fully elucidated, but they possibly involve elevated prolactin levels (Olusi. 1980) and in the end you are probably better off with gyno than with a malignant germ cell tumor, which is something frequent marijuana users are 2x more prone to develop than their non-smoking peers (Trabert. 2010; Lacson. 2012) .
I guess, I could find a couple of dozen additional references and continue this list of potential unwanted side effects, but I am not going to waste any further time I could invest on relevant SuppVersity news...



The 70s, that was a time! A time, when the average American still had a 20% lower BMI, being normal weight was still the norm and models like those in the photo above did not have to be anorexic all because of the weed?
Bottom line: While you may escape becoming a dumb, impotent home to various forms of cancer as a consequence of developing diabetes, you better be careful with your cannabis use or you just take another route towards the same detrimental outcomes - a route from which you cannot escape by healthy dieting and working out. If that's a risk you are willing to take - go ahead, but don't forget that the "cannabis vs. diabetes" study does not provide any evidence for a causal relationship between the reduced incidence of insulin resistance and obesity and smoking weed. It's the same statistical shenanigan that will tell you that eggs cause heart disease (learn that they don't) and that eating fat will make you fat.

In the end, cannabis is a drug - a drug with effects and side effects... or, as we should finally admit for "regular" drugs as well dietary supplements with effects we classify as desirable (classic effects) and undesirable (side effects). Against that background you may consider today's SuppVersity article as the patient information leaflet that goes with the "diabetes drug cannabis". Now you decide if you feel that the potential advantages outweigh the way better researched potential side effects.

References:
  • Aversa A, Rossi F, Francomano D, Bruzziches R, Bertone C, Santiemma V, Spera G. Early endothelial dysfunction as a marker of vasculogenic erectile dysfunction in young habitual cannabis users. Int J Impot Res. 2008 Nov-Dec;20(6):566-73. 
  • Banerjee A, Singh A, Srivastava P, Turner H, Krishna A. Effects of chronic bhang (cannabis) administration on the reproductive system of male mice. Birth Defects Res B Dev Reprod Toxicol. 2011 Jun;92(3):195-205. 
  • Dardick KR. Holiday gynecomastia related to marijuana? Ann Intern Med. 1993 Aug 1;119(3):253.
  • Gorzalka BB, Hill MN, Chang SC. Male-female differences in the effects of cannabinoids on sexual behavior and gonadal hormone function. Horm Behav. 2010 Jun;58(1):91-9.
  • Hanson KL, Winward JL, Schweinsburg AD, Medina KL, Brown SA, Tapert SF. Longitudinal study of cognition among adolescent marijuana users over three weeks of abstinence. Addict Behav. 2010 Nov;35(11):970-6. 
  • Harmon J, Aliapoulios MA. Gynecomastia in marihuana users. N Engl J Med. 1972 Nov 2;287(18):936. 
  • Kolodny RC, Masters WH, Kolodner RM, Toro G. Depression of plasma testosterone levels after chronic intensive marihuana use. N Engl J Med. 1974 Apr 18;290(16):872-4.  
  • Kulhalli V, Isaac M, Murthy P. Cannabis-related psychosis: Presentation and effect of abstinence. Indian J Psychiatry. 2007 Oct;49(4):256-61. 
  • Lacson JC, Carroll JD, Tuazon E, Castelao EJ, Bernstein L, Cortessis VK. Population-based case-control study of recreational drug use and testis cancer risk confirms an association between marijuana use and nonseminoma risk. Cancer. 2012 Nov 1;118(21):5374-83.
  • Mandal TK, Das NS. Testicular toxicity in cannabis extract treated mice: association with oxidative stress and role of antioxidant enzyme systems. Toxicol Ind Health. 2010 Feb;26(1):11-23.
  • Meier MH, Caspi A, Ambler A, Harrington H, Houts R, Keefe RS, McDonald K, Ward A, Poulton R, Moffitt TE. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proc Natl Acad Sci U S A. 2012 Oct 2;109(40):E2657-64.
  • Olusi SO. Hyperprolactinaemia in patients with suspected cannabis-induced gynaecomastia. Lancet. 1980 Feb 2;1(8162):255.
  • Penner EA, Buettner H, Middleman MA. The impact of marijuana use on glucose, insulin, and insulin resistance among US adults.Am J Med. 2013;126:XX-XX
  • Ruiz-Veguilla M, Barrigón ML, Hernández L, Rubio JL, Gurpegui M, Sarramea F, Cervilla J, Gutiérrez B, James A, Ferrin M. Dose-response effect between cannabis use and psychosis liability in a non-clinical population: Evidence from a snowball sample. J Psychiatr Res. 2013 May 16. 
  • Saso L. Effects of drug abuse on sexual response. Ann Ist Super Sanita. 2002;38(3):289–96 .
  • Schweinsburg AD, Brown SA, Tapert SF. The influence of marijuana use on neurocognitive functioning in adolescents. Curr Drug Abuse Rev. 2008 Jan;1(1):99-111.
  • Shamloul R, Bella AJ. Impact of cannabis use on male sexual health. J Sex Med. 2011;8(4):971–5.
  • Takeda S, Yamamoto I, Watanabe K. Modulation of Delta9-tetrahydrocannabinol-induced MCF-7 breast cancer cell growth by cyclooxygenase and aromatase. Toxicology. 2009 May 2;259(1-2):25-32.
  • Trabert B, Sigurdson AJ, Sweeney AM, Strom SS, McGlynn KA. Marijuana use and testicular germ cell tumors. Cancer. 2011 Feb 15;117(4):848-53. doi: 10.1002/cncr.25499. Epub 2010 Oct 5.
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