CBD for Type 2 Diabetes: What Are the Benefits and Risks?
The trendy complementary treatment is rising in popularity. Here’s what you need to know before you use CBD to manage type 2 diabetes.
You probably don’t have to look farther than your local drugstore or beauty product supplier to know CBD has taken a starring role in everything from sparkling water and gummies to tincture oils and lotions. Some may even say that cannabidiol (CBD) — which, like THC, is a component of the cannabis plant, but doesn’t contain its psychoactive effects — is the “it” ingredient of our age.
You’ve probably also heard that CBD can help lessen stress, anxiety, and pain. “When people are in pain, they have a stress response, which causes an increase in cortisol and an increase in blood sugar,” says Veronica J. Brady, PhD, CDCES, a registered nurse and an assistant professor at the Cizik School of Nursing at the University of Texas in Houston. Relieving pain can help alleviate the stress response and improve blood sugar levels, as well as aid sleep, she says.
If you’re managing type 2 diabetes, it’s natural to be curious about whether CBD might help you manage those symptoms, too, to help stabilize your blood sugar. In fact, the prevalence of cannabis use increased by 340 percent among people with diabetes from 2005 to 2018, according to a study published in Drug and Alcohol Dependence in July 2020, which surveyed people on their use of cannabis (CBD or THC, in any form) in the previous 30 days.
But does it work for treating diabetes? Some healthcare professionals say CBD may have a role to play, but it’s important to understand that the only health condition CBD has proved effective for is epilepsy in kids. The jury is unfortunately still out, owing to the lack of comprehensive research on CBD and type 2 diabetes.
Still, in the aforementioned survey, 78 percent of people used cannabis that was not prescribed by a doctor. “Diabetes patients might still use cannabis for medical reasons, but not have a prescription,” says Omayma Alshaarawy, MBBS, PhD, an assistant professor in the department of family medicine at Michigan State University in East Lansing, who led the study. Recreational use is another factor. She points to a separate study, published September 2019 in the Journal of the American Medical Association, that found that more than 50 percent of people with medical conditions such as diabetes or cancer use cannabis recreationally.
How People With Type 2 Diabetes Are Using CBD
In Nevada, where Dr. Brady used to work as a certified diabetes educator, her patients with type 2 diabetes used CBD for nerve pain. She says patients would use CBD in a tincture or in oils that they rubbed on painful areas, including their feet. Patients could buy CBD at medical marijuana dispensaries, which would offer dosing instructions. “They worried about the impact on their blood sugars,” says Brady.
Ultimately, though, Brady says that her patients reported that CBD reduced their nerve pain and improved their blood sugar. She adds that those people who used CBD oils for nerve pain also reported sleeping better.
Heather Jackson, the founder and board president of Realm of Caring in Colorado Springs, Colorado, a nonprofit that focuses on cannabis research and education, senses an interest in CBD within the diabetes community. “In general, especially if they’re not well controlled, people are looking at cannabinoid therapy as an alternative, and usually as an adjunct option,” says Jackson. Callers have questions about CBD for neuropathy pain, joint pain, gastrointestinal issues, and occasionally blood glucose control, according to a spokesperson for Realm of Caring.
The organization receives thousands of inquiries about cannabis therapies a month. It keeps a registry of these callers, where they live, and their health conditions. Jackson says that people with type 2 diabetes are not a large percentage of the callers, but they currently have 540 people with diabetes in their database.
Jackson says that Realm of Caring does not offer medical advice, and it does not grow or sell cannabis. Instead, it offers education for clients and doctors about cannabis, based on its ever-growing registry of CBD users, their conditions, side effects, and administration regimen. “We are basically educating,” says Jackson. “We want you to talk to your doctor about the information you receive.”
Scientific Studies on CBD and Type 2 Diabetes, and Barriers to Research
Despite interest among people with type 2 diabetes, large, rigorous studies showing how CBD may affect type 2 diabetes are lacking, says Y. Tony Yang, MPH, a doctor of science in health policy and management and a professor at George Washington University School of Nursing in Washington, DC. Specifically absent are randomized controlled trials, which are the gold standard of medical research.
Early research suggests CBD and diabetes are indeed worth further study. For example, a small study published in October 2016 in Diabetes Care in the United Kingdom looked at 62 people with type 2 diabetes and found that CBD did not lower blood glucose. Participants were not on insulin, but some took other diabetes drugs. They were randomly assigned to five different treatment groups for 13 weeks: 100 milligrams (mg) of CBD twice daily; 5 mg of THCV (another chemical in cannabis) twice daily; 5 mg CBD and 5 mg THCV together twice daily; 100 mg CBD and 5 mg of THCV together twice daily; or placebo. In their paper, the authors reported that THCV (but not CBD) significantly improved blood glucose control.
Other CBD research is still evolving. Some CBD and diabetes studies have been done in rats, which leads to findings that don’t always apply to human health. Other studies have looked more generally at the body’s endocannabinoid system, which sends signals about pain, stress, sleep, and other important functions. Still other studies, including one published in the American Journal of Medicine, have looked at marijuana and diabetes, but not CBD specifically.
That there are so few studies of CBD in people with type 2 diabetes has to do with a lack of focus on CBD as an individual component. Historically, cannabinoids (a group of chemicals in the cannabis plant) have been lumped together, including CBD, THC, and more than 100 others. The 1970 U.S. Controlled Substances Act classifies cannabis as a Schedule 1 drug with the highest restrictions. Currently, 33 states and the District of Columbia allow cannabis for medical use and 11 states allow cannabis for recreational use.
The 2018 Farm Bill removed industrial hemp from the controlled substances list, clearing the way for more production and research of CBD. Meanwhile, growers and manufacturers are better able to isolate CBD, mainly by cultivating industrial hemp that is high in CBD and very low in THC, says Jackson. So, perhaps in the coming years, more research on CBD and diabetes will emerge.
How the FDA Views and Regulates CBD for Disease Treatment
Yet, as evidenced by the July 2020 study in Drug and Alcohol Dependence, people with type 2 diabetes aren’t waiting for further study to hop on the trend. Brady says her patients have been open about using CBD, particularly the younger patients. She says one of her older patients was initially uncomfortable about buying CBD in the same shop that sold marijuana but eventually gave in. Brady adds that many people associate CBD with smoking marijuana, despite their distinctly different effects on the body.
The U.S. Food and Drug Administration (FDA) approved the first CBD medication in 2018, for treating childhood epilepsy. Currently, there is no other FDA-approved CBD medication for diabetes or any other condition, according to the FDA. In December 2018, the FDA said it was unlawful under the Federal Food, Drug, and Cosmetic Act to sell food or dietary supplements containing CBD. In April 2019, the FDA stated that it would be taking new steps to evaluate cannabis products, and it held a public hearing about cannabis products in May 2019.
“The FDA, for the time being, has focused its limited enforcement resources on removing CBD products that make claims of curing or treating disease, leaving many CBD products for sale,” wrote Pieter Cohen, MD, and Joshua Sharfstein, MD, in a July 2019 perspective in the New England Journal of Medicine. Dr. Cohen is an assistant professor of medicine at Harvard Medical School in Boston, and Dr. Sharfstein oversees the office of public health practice and training at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
Precautions for People With Diabetes Looking to Try CBD
For the CBD products already on the market, Jackson says it’s often difficult to know what’s inside. A study published November 2017 in the Journal of the American Medical Association found that only 30 percent of CBD products were accurately labeled, with under- and over-labeling of CBD content, and some products containing unlisted chemicals such as THC.
Vaping liquids were the most commonly mislabeled CBD products in the study. The International Research Center on Cannabis and Health in New York City warns that consumers should not purchase vape products from unregulated and illicit markets. A small investigation by the Associated Press in 2019 showed that some CBD vapes had synthetic marijuana.
Jackson points out that CBD may affect certain cholesterol and blood pressure drugs, and a study published in June 2017 in Cannabis and Cannabinoid Research detailed these interactions. Other side effects of CBD include tiredness, diarrhea, and changes in weight or appetite, the researchers write.
“What you put in your body is really important,” says Jackson, adding that’s especially true for people with major health conditions like diabetes. Jackson speaks from personal experience as a mom finding CBD treatments for her son’s epilepsy. She says consumers should ask manufacturers whether CBD products are free of mold, pesticides, and other toxins.
Realm of Caring, Jackson’s nonprofit, created a reference sheet for evaluating products and manufacturers. It also endorses products that adhere to standards such as those from the American Herbal Products Association and the FDA’s Current Good Manufacturing Practice regulations.
“There is little known about cannabis health effects, especially among patients with chronic conditions. Research is growing, but still solid evidence evolves,” says Dr. Alshaarawy. For these reasons, she recommends that patients talk to their doctors so they can discuss the benefits and potential harms of cannabis and monitor their health accordingly.
How to Talk to Your Healthcare Provider About Using CBD for Type 2 Diabetes
Jackson and Brady advise people who are considering CBD for diabetes to ask their providers about the complementary therapy before adding it to their treatment plan. Brady says it’s difficult to find research about CBD and type 2 diabetes, even in her capacity as a diabetes educator. Still, in her experience, if people are looking for a natural way to manage pain, it’s worth a conversation with their healthcare provider. “It’s something that should be talked about, especially if they’re having significant amounts of pain, or really any pain at all associated with their diabetes,” says Brady.
“It’s a reasonable alternative,” says Brady. “As it gains in popularity, there needs to be some information out there about it.
There’s a lack of rigorous research on how CBD may affect type 2 diabetes, but early studies and anecdotal reports suggest it may help manage stress, anxiety, and pain. Learn more about using CBD to control your blood sugar.
Can CBD Oil Be Used to Treat or Prevent Diabetes? What the Research Says
The use of CBD to ease the symptoms of diabetes — as well as epilepsy, anxiety, and a wide range of other health conditions — is showing promise, though research is still limited.
CBD is short for cannabidiol, a compound found in the cannabis plant. The other major compound is tetrahydrocannabinol (THC), the ingredient that produces a “high.” CBD has no such psychoactive properties.
Among the ongoing areas of research are whether CBD may help treat or even lower the risk of developing both type 1 and type 2 diabetes.
Animal and human studies have looked at CBD’s effects on levels of insulin, blood glucose (sugar), and inflammation, as well as complications of diabetes, such as the pain associated with diabetic neuropathy.
Read on to learn the results of these studies and how you might use CBD to potentially help prevent diabetes or alleviate some of its symptoms.
|CBD associated with improvements||CBD not yet shown to be effective|
|diabetes prevention||HDL cholesterol levels|
|inflammation||blood glucose levels|
Type 1 and type 2 diabetes differ in their origin and treatment, but they present the same problem: too much glucose circulating in the blood.
Our bodies use the hormone insulin to help regulate blood glucose levels. When you eat, the pancreas produces insulin, which acts as a key, unlocking certain cells to allow glucose from the foods and beverages you consume to enter the cells to be used for energy later.
About 5 percent of people with diabetes have type 1, which occurs when the body produces little or no insulin. This means glucose remains in the bloodstream, injuring blood vessels and depriving cells of fuel.
The vast majority of diabetes cases are type 2 diabetes , which develops when cells no longer respond to insulin. That’s called insulin resistance, and the result is also too much circulating glucose. Insulin resistance also boosts inflammation levels in the body.
Research findings are mixed when it comes to whether CBD can have a positive effect on diabetes symptoms and complications. CBD has been associated with improvements in the following:
There have been no clinical trials to test whether CBD oil consumption can actually lower the risk of developing diabetes in humans.
However, a study in the journal Autoimmunity found that nonobese diabetic (NOD) mice had a substantially lower risk of developing diabetes if treated with CBD.
CBD has been studied as an anti-inflammatory treatment for several years.
In a study specifically looking at inflammation triggered by high glucose levels, researchers found that CBD had positive effects on several markers of inflammation.
This study suggests that CBD may be helpful in offsetting the damage diabetes can inflict on the walls of blood vessels.
A 2017 study of rats in the journal Pain found that CBD helped reduce inflammation and nerve pain associated with osteoarthritis.
Another study, published in the Journal of Experimental Medicine, showed CBD was effective in suppressing chronic inflammatory and neuropathic pain in rodents.
There’s no evidence yet (although research is ongoing) that CBD is effective at improving HDL cholesterol levels or managing blood glucose.
In a small 2016 study in the journal Diabetes Care , researchers found CBD use had little impact on HDL (“good”) cholesterol levels and several other markers, such as insulin sensitivity and appetite, on people with type 2 diabetes.
When it comes to potential diabetes treatments, the biggest concern is how it may help manage blood glucose levels.
At this point, there are no significant studies confirming CBD or CBD oil as a means of reducing high levels of blood sugar.
Other medications, such as metformin — together with a healthy diet and exercise — should be the main focus of your diabetes treatment and management. And if you need insulin, continue taking it as prescribed by your doctor.
CBD oil is produced by extracting CBD from the cannabis plant and diluting it with a carrier oil, such as coconut or hemp seed oil.
Forms of CBD
Forms of CBD that you can use to potentially relieve symptoms of diabetes include:
- Vaping. Inhaling vaporized CBD oil (with the use of vaping pens or e-cigarettes) is the fastest way to experience effects. Compounds are absorbed directly from the lungs into the bloodstream. However, vaping could cause other harmful side effects such as airway irritation or damage.
- Oils and tinctures. Oils placed (via dropper) under the tongue absorb quickly into the bloodstream. Drops can also be added to foods or beverages.
- Edibles. These gummy-like candies or chocolates are good options for those who have trouble swallowing pills. Time from ingestion to effect can take a while.
- Pills and capsules. CBD pills and capsules contain a version of an oil or tincture. The time from ingestion to effect can take a while.
- Skin creams and lotions. Topical CBD creams are often applied to the skin to ease muscle or joint pain. Most topicals don’t enter the bloodstream. Instead, they affect local cannabinoid receptors in the skin.
Talk with a doctor about which CBD brands and products may be best for you and at what dosage you should start your treatment.
When starting any new drug or supplement, it’s usually best to start with a low dose. This way you can see how well you tolerate it and whether it’s effective at that dose.
An extensive review of CBD’s existing clinical data and animal studies reported that CBD is safe and has few, if any, side effects for adults.
Most common side effects are:
- changes in appetite
- changes in weight
Since CBD is often used in addition to other prescriptions or over-the-counter drugs, more research is needed to understand how the cannabinoid interacts with other meds.
Using CBD may increase or inhibit another drug’s effectiveness or side effects. Talk to your doctor before taking CBD.
This is especially important if you’re taking medications that come with a “grapefruit warning.” Grapefruit and CBD both interact with an enzyme that’s vital to drug metabolism.
Early studies looking at CBD as a possible diabetes treatment have shown encouraging results, particularly in the areas of prevention, inflammation, and pain.