An estimated 213,000 persons have been diagnosed with type 2 diabetes in Jamaica (DigJamaica).
In 2011, the National Health Fund had 106,017 persons with diabetes enrolled and they disbursed $616,461,903 to beneficiaries for diabetes alone (DigJamaica). These treatments consist of imported pharmaceuticals. These imports are contributing to Jamaica’s trade deficit. This deficit can be narrowed if we were able to develop our own therapeutic moiety and import less by manufacturing our own product, possibly using a local, natural resource.
Is there a role for cannabis sativa in the prevention and treatment of this disease and its complications? The following is a review of research involving the effects of cannabis sativa on diabetes.
It is common knowledge that the effects of cannabis sativa is as a result of activation of the cannabinoid system. Several studies have demonstrated the presence of cannabinoid 1 (CB1) receptors as well as the enzymes needed to catalyze the biosynthesis and degradation of the endocannabinoids, 2-arachidonoylglycerol (2-AG) and anandamide (AEA) in the ß cells of human and mouse islet. In addition studies have shown that the synthesis of endocannabinoids by ß cells is dependent on glucose levels (Kim et al., 2012). It has also been reported that endocannabinoids regulate the insulin receptor signaling insulin sensitive tissues such as muscle, liver and islet of Langerhans. (Kim et al., 2012). In-vitro studies have shown that insulin and glucagon secretion were enhanced upon stimulation of CB1 receptors (Scheen, 2009). In a study by Li et al., (2011), it was found that the endocannabinoid, 2-AG, in the presence of 2 mM of glucose caused a seven-fold increase in insulin secretion over the level in the absence of the cannabinoid. Unexpectedly, they found the CB1 receptor antagonists to produce the same effect rather than reduce the secretion of insulin as would be expected. Kim et al (2012) found that there was an increase in endocanabinoid levels in the presence of diabetes and obesity.
In examining the relationship between cannabis smoking and diabetes mellitus, Alshaarawy and Anthony (2015) conducted a meta analysis of eight independent studies. They concluded that there was an inverse relationship between marijuana smoking and type 2 diabetes mellitus as well as a possible protective relationship. Epidemiological studies have shown that cannabis smoking have resulted in increased appetite and a higher than average intake of calories than nonusers (Penner, Buettner, & Mittleman, 2013). Despite the increased caloric intake marijuana users have lower body mass index, a lower prevalence of obesity and diabetes. Studies by Weiss et al. (2008) showed that cannabidiol (CBD) reduced the incidence of diabetes (type 1) in non- obese diabetic mice. The incidence in CBD treated mice was 30% compared to 86% in those not treated. The mice chosen for the study had developed insulitis which is similar to the
immunological state type 1 diabetes in humans. The onset of diabetes was 20 weeks for the CBD treated mice and 14 weeks for those not treated.
Studies have also shown that cannabis sativa is not only useful in controlling or preventing diabetes, but it is also useful in the complications of diabetes. Cannabis extract was found to be very effective in treating diabetic nerve pain (DNP) in a study by Comelli, Bettoni, Colleoni, Giagnoni, and Costa (2009). Reduction in the levels of nerve growth factor in the sciatic nerve has been implicated in DNP. After treatment with the cannabis extract, the levels were restored.
These are but a few of the research conducted, most of which have concluded that cannabis sativa is beneficial in the prevention and control of diabetes and diabetic neuropathy.
By: Marcia Williams, PHD, Msc, PgD. Ed, BPharm, RPH
Programme Director, School of Pharmacy
College of Health Sciences, University of Technology, Jamaica
Alshaarawy, O., & Anthony, J. C. (2015). Cannabis smoking and diabetes mellitus: Results from meta-analysis with eight independent replication samples. Epidemiology (Cambridge, Mass.), 26(4), 597-600. doi:10.1097/EDE.0000000000000314 [doi]
Comelli, F., Bettoni, I., Colleoni, M., Giagnoni, G., & Costa, B. (2009). Beneficial effects of a
cannabis sativa extract treatment on diabetes‐induced neuropathy and oxidative stress. Phytotherapy Research, 23(12), 1678-1684.
Kim, W., Lao, Q., Shin, Y. K., Carlson, O. D., Lee, E. K., Gorospe, M., . . . Egan, J. M. (2012). Cannabinoids induce pancreatic beta-cell death by directly inhibiting insulin receptor activation. Science Signaling, 5(216), ra23. doi:10.1126/scisignal.2002519 [doi]
Li, C., Bowe, J., Huang, G., Amiel, S., Jones, P., & Persaud, S. (2011). Cannabinoid receptor
agonists and antagonists stimulate insulin secretion from isolated human islets of langerhans. Diabetes, Obesity and Metabolism, 13(10), 903-910.
Penner, E. A., Buettner, H., & Mittleman, M. A. (2013). The impact of marijuana use on glucose, insulin, and insulin resistance among US adults. The American Journal of Medicine, 126(7), 583-589.
Scheen, A. J. (2009). The endocannabinoid system: A promising target for the management of type 2 diabetes. Current Protein and Peptide Science, 10(1), 56-74.
Weiss, L., Zeira, M., Reich, S., Slavin, S., Raz, I., Mechoulam, R., & Gallily, R. (2008).
Cannabidiol arrests onset of autoimmune diabetes in NOD mice. Neuropharmacology, 54(1), 244-249.
http://www.digjamaica.com/diabetes, The Gleaner. Retrieved May 28, 2017