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PurpleSkyz

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Marijuana, blood sugar control linked, study says


Friday, May 24, 2013













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May 24, 2013 (PHILADELPHIA) --
Regular marijuana use is associated with favorable indices related to
diabetic control, say investigators. They found that current marijuana
users had significantly lower fasting insulin and were less likely to be
insulin resistant, even after excluding patients with a diagnosis of
diabetes mellitus. Their findings are reported in the current issue of
The American Journal of Medicine.

Marijuana has been used for centuries to relieve pain, improve
mood and increase appetite. Outlawed in the United States in 1937, its
social use continues to increase and public opinion is swinging in favor
of the medicinal use of marijuana. There are an estimated 17.4 million
current users of marijuana in the United States. Approximately 4.6
million of these users smoke marijuana daily or almost daily. A
synthetic form of its active ingredient, tetrahydrocannabinol, commonly
known as THC, has already been approved to treat side-effects of
chemotherapy, AIDS-induced anorexia, nausea, and other medical
conditions. With the recent legalization of recreational marijuana in
two states and the legalization of medical marijuana in 19 states and
the District of Columbia, physicians will increasingly encounter
marijuana use among their patient populations.
A multicenter
research team analyzed data obtained during the National Health and
Nutrition Survey (NHANES) between 2005 and 2010. They studied data from
4,657 patients who completed a drug use questionnaire. Of these, 579
were current marijuana users, 1,975 had used marijuana in the past but
were not current users, and 2,103 had never inhaled or ingested
marijuana. Fasting insulin and glucose were measured via blood samples
following a nine hour fast, and homeostasis model assessment of insulin
resistance (HOMA-IR) was calculated to evaluate insulin resistance.
Participants who reported using marijuana in the past month had lower
levels of fasting insulin and HOMA-IR and higher levels of high-density
lipoprotein cholesterol (HDL-C). These associations were weaker among
those who reported using marijuana at least once, but not in the past
thirty days, suggesting that the impact of marijuana use on insulin and
insulin resistance exists during periods of recent use. Current users
had 16% lower fasting insulin levels than participants who reported
never having used marijuana in their lifetimes.
Large waist
circumference is linked to diabetes risk. In the current study there
were also significant associations between marijuana use and smaller
waist circumferences.
"Previous epidemiologic studies have found
lower prevalence rates of obesity and diabetes mellitus in marijuana
users compared to people who have never used marijuana, suggesting a
relationship between cannabinoids and peripheral metabolic processes,
but ours is the first study to investigate the relationship between
marijuana use and fasting insulin, glucose, and insulin resistance,"
says lead investigator Murray A. Mittleman, MD, DrPH, of the
Cardiovascular Epidemiology Research Unit at the Beth Israel Deaconess
Medical Center, Boston.
"It is possible that the inverse
association in fasting insulin levels and insulin resistance seen among
current marijuana users could be in part due to changes in usage
patterns among those with a diagnosis of diabetes (i.e., those with
diabetes may have been told to cease smoking). However, after we
excluded those subjects with a diagnosis of diabetes mellitus, the
associations between marijuana use and insulin levels, HOMA-IR, waist
circumference, and HDL-C were similar and remained statistically
significant," states Elizabeth Penner, MD, MPH, an author of the study.
Although people who smoke marijuana have higher average caloric intake
levels than non-users, marijuana use has been associated with lower
body-mass index (BMI) in two previous surveys. "The mechanisms
underlying this paradox have not been determined and the impact of
regular marijuana use on insulin resistance and cardiometabolic risk
factors remains unknown," says coauthor Hannah Buettner.
The
investigators acknowledge that data on marijuana use were self-reported
and may be subject to underestimation or denial of illicit drug use.
However, they point out, underestimation of drug use would likely yield
results biased toward observing no association.
Editor-in-Chief
Joseph S. Alpert, MD, Professor of Medicine at the University of Arizona
College of Medicine, Tucson, comments, "These are indeed remarkable
observations that are supported, as the authors note, by basic science
experiments that came to similar conclusions.
"We desperately
need a great deal more basic and clinical research into the short- and
long-term effects of marijuana in a variety of clinical settings such as
cancer, diabetes, and frailty of the elderly," continues Alpert." I
would like to call on the NIH and the DEA to collaborate in developing
policies to implement solid scientific investigations that would lead to
information assisting physicians in the proper use and prescription of
THC in its synthetic or herbal form."




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