Cannabis linked to better blood sugar control, says new study

Recent research has explored the complex relationship between the cannabis use and diabetes, offering insights that could change our understanding of potential health effects of cannabis.

Cannabis and diabetes

Cannabis users may have a «healthier inflammatory cytokine profile, better insulin sensitivity and higher levels of physical activity than non-users», according to ongoing research in the SONIC trial.

Angela Bryan, PhD, professor and co-director of CUChange at the University of Colorado at Boulder, and her team hypothesized that «these inflammatory profiles would improve over the four weeks, particularly for those using a cannabidiol-based product (CBD) as opposed to a product based on tetrahydrocannabinol (THC) ».

This research was presented at the 84th annual scientific session of the’American Diabetes Association.

Exercise and fun

Bryan's work also focuses on the public health consequences of cannabis legalization. One study examined the acute effects of legally traded cannabis on the subjective reactions of regular users while running. It revealed that cannabis use before exercise could lead to greater enjoyment and symptoms of runner euphoria, even if it also led to a greater sense of effort. These positive effects could make exercise more attractive to people, including those suffering from or at risk of diabetes, who might not otherwise engage in it.

Another study by Bryan and colleagues revealed that the CBD-dominant forms of cannabis were associated with an acute reduction in blood pressure, which could reduce anxiety in the longer term. These findings could be particularly relevant in the context of diabetes-related distress, offering a potential avenue for improving mental health outcomes in diabetic patients.

SONIC study: detailed results

In SONIC study, The participants who regularly used cannabis were predominantly young, with an average age of 30, and had body mass indices in the healthy range. Study participants were predominantly Caucasian (86 %) and male (59 %). They were matched with a similar group of people who had not used cannabis for at least a year.

At the start of the study, the NSDR Healthy Eating Index score was 51.24, indicating a «need for improvement/poor diet». However, Bryan noted that «people may not have been up to scratch in the area of diet, but they were absolutely up to scratch in the area of physical activity».

Researchers performed oral glucose tolerance tests to calculate participants' Matsuda Insulin Sensitivity Index, and measured various inflammatory markers. As part of a randomized incentive plan, users were invited to purchase and use a floral product for four weeks, consuming as much as they wished. They made daily assessments of their cannabis and alcohol consumption, diet and physical activity.

After 4 weeks, the study revealed no change in participants' inflammatory markers. However, a significant difference was observed between users and non-users, with cannabis users showing higher significantly lower levels of inflammatory biomarkers and circulating cytokines. The exception was levels of monocyte chemoattractant protein-1 (MCP-1), which increased over time in users but remained unchanged in non-users. Bryan called this result «perplexing», given that MCP-1 levels are positively associated with diabetes.

Insulin sensitivity and study limitations

After controlling for BMI and inflammation, no effect of group or group-time interaction on Matsuda's insulin sensitivity index was observed. Bryan acknowledged that the study involved «a very healthy sample of people who exercise a lot, which could influence our results, particularly with regard to insulin sensitivity».

In addition, the impossibility of using «gold standard» randomization due to the scheduling of cannabis in Schedule 1, and the difficulty of interpreting MCP-1 results, were identified as limitations of the study.

Daily data showed only slight differences in behavior between cannabis users and non-users, as well as between the behavior of users on days when they used cannabis and days when they didn't. Bryan concludes, «I think all this evidence together tells us that the relationship between cannabis use and potential implications for diabetes is much more complex than just couchlock [very deep relaxation/sedation] or runner's high.»

The next step for Bryan's team is to obtain an acute response to cannabis by performing an oral glucose tolerance test immediately after the participant has consumed a product. Due to the classification of cannabis in Annex 1, However, this test cannot be carried out in a laboratory. The researchers therefore use a CannaVan, a mobile laboratory that travels to participants' homes. Participants consume their cannabis product at home, then return to the van for follow-up assessments and blood tests. Bryan plans to share these results in future presentations.