There’s not a lot of research on how cannabis use may impact those who have diabetes, says Scott Pilla, MD, a member of the American Diabetes Association’s professional practice committee and an assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore. “In general,” Dr. Pilla says, “it is not recommended … there really is very little research on long-term cannabis use, either as a therapeutic or recreationally.”
Health authorities generally recommend against the use of cannabis, for people both with and without diabetes, but there are clinicians who support its use. Desiree Granados, MD, an integrative medicine specialist in Fort Myers, Florida, who specializes in weight and blood sugar management, says she generally considers cannabis safe for those who have diabetes.
Nevertheless, there are some obvious risks for people with diabetes involved with using any psychoactive substance. Cannabis can have mind-altering effects that could overlap with or mask the signs of both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia). When you’re high on cannabis, it can be difficult to recognize when you need to take action or to make good self-care decisions.
Cautious cannabis users with diabetes recommend being extra careful while using the substance. Consider wearing a continuous glucose monitor (CGM) to remind you to check your blood glucose levels. And never use so much of the drug that it could impair your ability to take your medicine or recognize when you may be experiencing a blood-sugar related problem. It might be wise to use cannabis in the company of a sober friend or family member who understands your condition and can help you make good decisions in an emergency.
The “munchies” can also represent a significant hazard, especially for people who use insulin, says Pilla. “Anything that causes variations in dietary intake can cause hypoglycemia, especially for people using insulin who need to follow a good routine, so cannabis use would be a concern for me for anyone using insulin.”
“Some strains of cannabis can cause people to have an increased appetite, which could potentially lead to overeating sugary or carb-heavy snacks, leading to increase in blood sugar levels,” Dr. Granados says. “However, there are other strains that may not cause any change in appetite at all. Everyone responds to specific cannabis strains differently.”
People with diabetes should also be aware of any cravings that might influence unhealthy snacking or eating habits while they’re under the influence of marijuana. And cannabis edibles themselves may include substantial amounts of added sugar.
There are other short- and long-term risks unrelated to diabetes, including lung disease (when inhaled), impaired driving disasters, mental health problems, and memory loss. “From what we know, cannabis use is likely to have some adverse health effects including lung issues for cannabis smokers, and possibly cardiovascular and cognitive issues,” says Pilla.
Cannabis use may also impact other health conditions that people with diabetes frequently face. For example, the American Heart Association warns that cannabis use appears to be linked to cardiovascular risk factors.
Cannabis is an addictive substance, and excessive use can cause physical, mental, and social problems that could significantly interfere with your health and diabetes management.
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