Disease Description

Type 2 diabetes mellitus is a disorder affecting the way your body uses glucose (sugar). Cells in your body need sugar to work normally and sugar gets into the cells with the help of the hormone called insulin. Without enough insulin, or if the body stops responding to insulin, sugar builds up in the blood.[1]

In type 2 diabetes mellitus, the pancreas does not make enough insulin, the body becomes resistant to normal or even high levels of insulin, or both. This causes high blood glucose (blood sugar) levels, which can cause serious problems if untreated.[1]

Type 2 diabetes is a medical condition that requires regular monitoring and treatment throughout your life. Fortunately, with proper treatment one can keep blood sugar levels close to normal and minimize the risk of developing complications.[1]

Prevalence

In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes. Diabetes remains the 7th leading cause of death in the United States in 2010, with 69,071 death certificates listing it as the underlying cause of death, and a total of 234,051 death certificates listing diabetes as an underlying or contributing cause of death. In the United States, Canada, and Europe, about 90 percent of all people with diabetes have type 2 diabetes.[2]

Current Treatment Options

Treatment includes lifestyle changes, self-care measures, and sometimes medications.A number of oral medicines (pills) are available to treat type 2 diabetes. [2]

Metformin — Most people who are newly diagnosed with type 2 diabetes will immediately begin a medicine called metformin (Glucophage, Glumetza, Riomet, Fortamet). Metformin improves how your body responds to insulin to reduce high blood sugar levels.[2]

Insulin — In the past, insulin treatment was reserved for patients with type 2 diabetes whose blood sugars were not controlled with oral medicines and lifestyle changes. However, there is increasing evidence that using insulin at earlier stages may improve overall diabetes control and help to preserve the pancreas's ability to make insulin.[2]

There are a number of additional medications on the market. You should consult with your health care provider to see which medications are right for you.

Evidence for and Proposed Mechanism for Cannabinoid Therapies

The study of the role of the endocannabinoids and their receptors in food intake and energy balance led, only little more than a decade after the identification of the endocannabinoid signaling system, to the development of several new therapeutic drugs. However due to unwanted side effects these drugs were eventually removed from the market.[3]

Rather than global obesity, often associated with depressive disorders, the indication novel cannabinoid compounds, as well as of other strategies aiming at reducing endocannabinoid overactivity, should be instead for those metabolic dysfunctions that are associated with abdominal obesity. For example, the administration of second-generation CB1 receptor antagonists to moderately obese patients is likely to improve considerably the benefit/risk ratio of these compounds and result in long-term beneficial outcomes on type 2 diabetes.[3]

1) UpToDate online resource

2) American Diabetes Association

3) Mechoulam et al. Cannabinoids and Endocannabinoids in Metabolic Disorders with Focus on Diabetes