Smoking Pot and Diabetes

About 10 years ago I wrote an article on pot and diabetes. Back then, cannabis was illegal almost everywhere in North America, so it was kind of difficult to get good informatioh.
A reader got my phone number and called in a question, "I hope I am not, like, you know, breaking any rules, but I would like to know, Diabetes Guy (he called me Diabetes Guy), if my pot smoking would, like, affect my son's diabetes." Dude, like, I was only too happy to give you an answer. Here's what I wrote 10 years ago:
You go on to mention that your son is 27 years old, also smokes pot, and lives with you. Sometimes you smoke together.

We'll stick to the topic of diabetes and marijuana.

Complications, and complicating the complications. The good news is that if you use marijuana regularly, you are less likely to suffer the tingling, burning, or stabbing pain caused by neuropathy. The effects of marijuana on pain are even greater if you are also depressed. The problem comes from the fact that when you stop feeling pain, you are still unable to feel. You need to be vigilant, whether you smoke pot or not, to make sure you don't get any burns, cuts, or scrapes that might be get infected and cause you serious problems. It happens a lot more often than you might think.

Marijuana and the progression of the disease. One of the common consequences of uncontrolled high blood sugars over about 10 years or so is that diabetics start needing to inject insulin. That's because the cells that make this vital hormone become so overactive that the immune system mistakes them for infection and "takes them out." There some evidence that some compounds in marijuana could make the immune system more "mellow," too, so this effect would not occur. However, the best way to prevent beta cell burnout is not to let your sugars run high in the first place! That's hard to do if you get a lot of attacks of the munchies.

Diabetics who absolutely, positively should not smoke pot. There is one group of diabetics, however, who absolutely should not use marijuana. Those are the diabetics who have hepatitis or any kind of chronic liver disease. The combination of the toxins (yes, there are toxins) released by the smoke and high blood sugars initiates a series of physiological reactions that causes fatty liver and cirrhosis of the liver. If you have liver disease and diabetes, smoking pot is actualy dangerous for you. It's not because of what it does to your blood sugar levels, but because of what it does to your liver.

Back then I had to add a legal disclaimer. Actually, I still do: Nothing in this article should be construed as an endorsement for smoking pot. This article is only intended to give the facts about marijuana and diabetes. It's not medical advice. It's just the simple facts as best I can present them as a layperson who cares. The one thing to remember is that taking care of diabetes is pretty much a full time job, and anything that keeps you from being diligent about is bad for your health.

Selected Reference:

Selvarajah D, Gandhi R, Emery CJ, Tesfaye S.

Randomized placebo-controlled double-blind clinical trial of cannabis-based medicinal product (Sativex) in painful diabetic neuropathy: depression is a major confounding factor.

Diabetes Care. 2010 Jan;33(1):128-30. Epub 2009 Oct 6.