Got questions about life with diabetes? So do we! That's why we offer our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1 and diabetes author Wil Dubois in New Mexico. This week, Wil takes on a serious question about drug use and diabetes -- specifically, methamphetamine. This is a follow-up to a question we received earlier in the year. While we certainly aren't endorsing meth use, here's to being honest and addressing the real questions that many in our community face...

{Got your own questions? Email us at AskDMine@diabetesmine.com}

 

Denny, type 2 from New Jersey, writes: After reading your response on crystal meth and diabetics I wonder if after (only) one use, does the drug leave the body, and if yes, how long will it take? I ask as I did crystal meth one time, and since then (30 days ago) my blood sugar levels have been, and are, still elevated. Could this only be a coincidence?

Wil@Ask D’Mine answers: Wow, what an interesting question. I sure as hell don’t want to glamorize meth in any way whatsoever. Breaking Bad has done enough on that front. With the obligatory "Don't Do Meth or Any Illegal Drug" out of the way, and in keeping with our Ask D'Mine charter that no question is off limits, I’m happy to talk meth with you, so to speak.

My first thought on reading it was that there was no way the meth could have a downstream effect that far out, and I wondered if some sort of waking-up-in-bed-with-a-stranger form of guilt was plaguing you, stressing you out, and raising your blood sugar.

But I learned long ago that it’s always best to do some research if I don’t have any personal experience on a subject, so I rang up all my druggie friends and doctors. (You can read that any way you want to.) What I found out was more complex than I ever dreamed.

Goodness me... Where to begin? OK, let’s start with your question about meth leaving the body: Yes, it does leave the body. But as to your companion question of how long it takes, that, as it turns out, is a trickier question.

Of course it varies with the precise blend of meth, and whether it’s ingested, smoked, or injected, but a meth high has an average duration of 8 to 12 hours. But then the meth hangs around in your body long after the high. Apparently, it remains detectable in your blood for up to three days, in your urine for up to six days, and in your hair for up to 90 days. That crap just doesn’t want to leave your body! 

Detection, of course, is a worry to those with random drug screenings at work or from probation officers; but to me detection is fascinating because if there’s still enough of a substance in the system to be detected, it could, in theory, still be having some sort of biological effect. Granted, not enough to give one a satisfying high, but perhaps enough of a one to eff’ with the blood sugar?

Now, while meth is in the body, it works its way into nearly every nook and cranny. Check out this cool study where researchers used a PET scanner to track the drug’s progress through the bodies of 10 volunteers. The highest uptake organs were the lungs, liver, and brain, but it also gets into… wait for it… the pancreas! Apparently, the body clears it out of the lungs the fastest, the brain the slowest, and gets it out of the pancreas at a sorta middle speed.

Speaking of getting the meth out, just how does the body attempt to clear this stubborn chemical? Apparently, it’s metabolized by the liver and excreted in the urine. I’ll spare you the details. When I was reading up on this it got so complex I fell asleep at my computer.

I guess I should’a taken a hit of meth to keep alert.

But if I had, would it have raised my blood sugar? I found plenty of evidence that it increases heart rate, blood pressure, body temp, and respiration rates, but what about sugar? What do we know about meth and glucose? 

Actually, that’s a bit of a mystery, but here are the skimpy facts as they exist. First, we do know that meth actually interferes with the brain’s ability to absorb glucose, hence the cognitive impairment sometimes seen in users. The drug makes you stupid by starving your brain cells. Does this lack of uptake by the biggest sugar hog in your body result in the unused supply of glucose building up in the blood? I don’t know. But maybe so, the prescribing info sheet on the commercially produced methamphetamine Desoxyn (used to treat attention deficit disorders) carries a warning about its use by people with diabetes, but only says “you will need to watch your blood sugar closely.”

Watch it do what? 

Meanwhile, in a study of 1,019 “methamphetamine-dependent patients” published in the journal Medicine, these individuals actually had a lower fasting blood glucose than the control subjects did. So if anything, recreational meth would seem to lower blood sugar, not raise it.

So in normal folks, while meth doesn’t seem to raise blood sugar, it sure seems to stay in the body, at least in small amounts, for a loooooong time. What if, rather than cause high blood sugar, meth somehow interferes with whatever diabetes medicine you take? While I found that study of a thousand crack heads… sorry, methamphetamine-dependent patients, I couldn’t find a study of a thousand diabetic crack heads. And even if such a study were undertaken, sorting out all the different meds used for blood sugar control would require an unmanageably large amount of data.

So it’s possible that your woes are the result of your one night stand with meth, but even I admit that it seems like a long shot. But if there’s no correlation between your meth mini-adventure and your elevated sugars—in other words, a coincidence, as you wondered—something is still causing your sugars to go up. So what might that be?

You need to round up all the usual suspects to investigate:

A month ago, did you start a new vial of injectable meds or a new bottle of pills? If pills, check the label to be sure the dose is right, then go on line to a pill finder and make sure the codes on your pills match the label. Sometimes pharmacies make mistakes. If you use an injectable, set it aside and break out a new vial or pen to see if your sugars return to normal. If they do, odds are the joy juice you’re now using got heat-damaged.

Next: Do you have a new girlfriend or any other changes in life that might either increase your eating or decrease your normal activity? If your life changes, so to must your diabetes meds.

After that, given that we know you (at least sometimes) engage in risky behavior, get checked for STDs. Any infection can raise blood glucose. An infection that lasts more than a month ain’t the common cold.

And lastly, don’t forget you have type 2 diabetes. OK. I’m sorry. That was a stupid thing to say. How can you forget that? What I was trying to say is to not forget the fundamental nature of type 2: It gets worse over time. Maybe your diabetes just got ahead of your meds. It likes to do that.

If that’s the case, you just need to visit your doc and get your meds amped up. One final note: You might also want to check out past posts here at D'Mine about meth, this "Meth-abetic Dangers" column from 2015 and this Call for Help in 2010 fielded by editor AmyT years ago.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.