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CBD for Diabetes?

Many people with chronic conditions like diabetes are turning to CBD because they believe that it can help restore balance and well-being — and there is an increasing amount of research to back it up.

With Junella Chin MD

As we learn more about the benefits of holistic wellness and alternative therapies, it becomes ever clearer that hemp products like CBD — scientifically known as cannabidiol — cannot be ignored. But what is CBD, and how can it possibly help people with chronic diseases like diabetes?

For a lot of people, CBD’s association with marijuana is enough to scare patients away from considering it. This can certainly cause anxiety if you are concerned about getting high, feeling cognitively impaired, or using an illegal product. CBD — as helpful as it’s shown to be — is still misunderstood. So, let’s dive into some of the facts around what CBD is and what it isn’t.

What is CBD?

First things first: CBD is a natural compound that is extracted from the Cannabis sativa plant. Yes, this is the same plant that tetrahydrocannabinol (aka THC, or marijuana) comes from — but CBD by itself is not marijuana and it cannot get you high.

Now, CBD can be extracted from both hemp and cannabis. Hemp is a non-psychoactive cannabinoid, meaning it can’t get you high like marijuana does. It carries almost no THC content (less than 0.3 percent, the legal limit) and it is not a controlled substance in the US. It is also not illegal.

Marijuana, on the other hand, contains much more THC and is a controlled substance. It is what produces a high or euphoric feeling.

When you use CBD, it’s the ratio between THC and CBD that makes the difference. Hemp-derived CBD contains less than 0.3 percent THC while marijuana-derived CBD contains 5 to 30 percent THC.

People who want the health benefits without the high (which includes many patients with chronic diseases and pain) will purchase hemp CBD oil that contains less than 0.3 percent THC or is entirely THC-free.

CBD is generally sold in the form of tinctures or oils, supplements, extracts, and gummies. It is also found in pain-relieving and calming gels, lotions, and bath salts. It’s not usually smoked.

Most of the CBD oils on the market are labeled “full-spectrum,” which means that they’re rich with almost all of the health-friendly compounds within the cannabis plant that are also not psychoactive. These include flavonoids (which are polyphenols and antioxidants), other cannabinoids, and terpenes (therapeutic compounds that have anti-inflammatory and antidiabetic effects). In other words, “full-spectrum” CBD contains natural compounds that can help boost your overall health and support your diabetes management regimen.

What does the research say about CBD?

To understand why CBD works, it’s best to understand how. First, CBD works with your endocannabinoid system, which is designed to promote homeostasis — or harmony — within your body. In fact, endocannabinoids are actually cannabis-like molecules made naturally within your body. When you use CBD, it influences or activates these receptors. It has also been found to influence non-cannabinoid receptors as well.

According to UCLA Health, “We now know the endocannabinoid system is involved in a wide variety of processes, including pain, memory, mood, appetite, stress, sleep, metabolism, immune function, and reproductive function. Endocannabinoids are arguably one of the most widespread and versatile signaling molecules known to man.”

One of the main reasons people turn to CBD is for chronic pain. The National Library of Medicine states that CBD oil has been found to provide relief for a variety of conditions, including chronic pain.

CBD has even influenced the creation of certain drugs. In fact, in June 2018, the first CBD-based drug was approved by the US Food and Drug Administration to help treat severe epilepsy.

Other studies have found that well-sourced CBD oils are found to have a host of benefits — many of which can be of help to diabetics. Beyond pain and epilepsy, CBD is used as a holistic remedy for:

  • insomnia
  • feelings of anxiety and obsessive behavior
  • fatigue
  • nausea
  • inflammation and oxidative stress

What does CBD do to help diabetes?

Perhaps most importantly, CBD has been shown to improve inflammation levels and oxidative stress (effects from free radicals within the body), says Dr. Junella Chin, Integrative MD and chief medical expert for Yesterday Wellness. “Cannabinoids work on nerve endings, reducing pain and inflammation. It can get to the heart of the problem versus taking a pain reliever, which is temporary.”

This can be a big deal, as diabetes is an inflammatory condition. Rampant inflammation can also cause insulin resistance.

The American Journal of Pathology found, “CBD was able to reduce oxidative stress, inflammation, cell death, and vascular hyperpermeability associated with diabetes,” noting that “oxidative stress and inflammation play critical roles in the development of diabetes and its complications.”

CBD may also improve insulin resistance and pancreas health. In a study on animal subjects with non insulin-treated type 2 diabetes, it was found that subjects who received CBD at 100 mg twice daily (as well as other treatments like tetrahydrocannabivarin, a phytocannabinoid), saw significantly decreased fasting plasma glucose and improved pancreatic health.

According to Rory Batt MSc, who studies the connection between the endocannabinoid system, CBD and type 2 diabetes, CBD may help boost pancreatic health in humans as well. “CBD can also help to protect the pancreas from becoming destroyed by overactive immune cells. Effectively, this means someone may be able to keep producing insulin themselves for longer. However, unless they ultimately change their diet as well, they will inevitably end up with a pancreas that cannot produce insulin—but CBD could significantly extend the time until that happens.”

Another potential benefit of CBD for diabetics? It can help improve diabetic neuropathy, says Dr. Chin. Diabetic neuropathy is a painful type of nerve damage that is caused by high blood sugars damaging nerves through the body. Patients often feel this in their feet or legs, and CBD can help relieve some of that discomfort and pain.

How does CBD work?

But how does it all work? CBD targets something called G-protein coupled receptors (GPCRs). Dr. Chin says these are some of the largest receptors in our bodies, playing a diverse role in bodily functions.

In fact, more than a third of our prescription drugs, including those for diabetes, are made to bind to GPCRs. “That’s how important it is. The fact that cannabinoids are the largest GPCR is why CBD may affect insulin resistance.”

According to Dr. Chin, CBD should be used as a long-term tool, not something you take here and there. “It’s best for long-term use because of its relatively safe profile and cumulative effects. Day one will be different from day 30. If you give it time, you may be able to turn the volume down on your inflammation.”

Reducing inflammation and disease activity requires a holistic approach, of course. Beyond using CBD, you’ll want to ensure you’re using your prescribed medications correctly, managing your stress levels, eating a colorful, anti-inflammatory diet (think veggies, fruits, and healthy fats), and exercising very regularly. All of these behaviors work together to reduce inflammation and help establish more balanced hormone levels.

Dr. Chin believes that CBD helps to treat some of the core issues behind diabetes, and that it can help improve overall diabetes lifestyle management. It’s not that CBD magically corrects insulin sensitivity right away, but rather that it can be helpful as part of a larger holistic regimen.

What should I know before I try CBD?

While enthusiasts have incorrectly lauded CBD as a miracle drug, it is more of a subtle supplement that can work differently for every person. Here are some tips for diabetes patients who want to try CBD for the first time:

  • Clear it with your doctor first. It’s smart to speak with your healthcare provider before starting a CBD regimen, especially if you’re using an array of medications, as CBD may interfere with drug metabolism in some instances.
  • Do your research. Because CBD isn’t regulated, it’s always best to do your research and buy your CBD from trustworthy sellers. Batt recommends making sure your CBD supplier is transparent about testing. “Use brands that test for heavy metals, mycotoxins and pesticides, as these can all disrupt endocrine function,” he says. Lord Jones is a reputable brand.
  • Consider “full-spectrum” CBD. Full-spectrum CBD, because of its cannabinoids, flavonoids, and terpenes, provides the ‘entourage effect’ that may be beneficial for inflammation and insulin resistance.
  • Experiment with dosage. If you’re going to use CBD, try aiming for 2.5 – 20 mg per day — but you may need to experiment with dosage and brand before seeing positive results. You can always increase your dosage, but you can’t take it down again. So, start at the lowest dosage and go from there.

CBD helps to quell inflammation, making it a new holistic option for diabetics to add to their health regimens.

CBD Oil for Diabetes?

Cannabis-Infused Cocktail CBD is turning up in everything from beauty products like lip balm and mascara to soda, coffee, infused waters and alcohol, too. (Photo: Unsplash)

Claims that cannabidiol oil—widely known as CBD oil or hemp oil—can help control blood sugar for people with Type 1 and Type 2 diabetes or even reverse diabetes are all over the Internet.

A quick Google search of the terms “CBD Oil” and “Diabetes” turns up 2.9 million hits, with promises and testimonials that the compound cannabidiol in this hemp- or marijuana-based oil could “stabilize blood sugar 1 ”, “improve insulin resistance 2 ”, “decrease the need for insulin 3 ” and even “suppress, reverse and perhaps cure the disease. 4 “

Trouble is, there’s no proof it can do any of those things.

“I don’t know that I would recommend CBD oil for diabetes,” notes integrative medicine doctor Taz Bhatia, MD, of Atlanta, Georgia, author of the books Super Woman RX and What Doctors Eat. “CBD is showing promise as a pain-reliever, an epilepsy treatment, and for wasting disease associated with cancer. It may help with neuropathic pain in diabetes. I think it is ok to try it, but don’t skip or cut back on diabetes medications.”

Eileen Konieczny, RN, past president of the American Cannabis Nurses Association and author of the book Healing with CBD: How Cannabidiol can Transform your Health without the High (Ulysses Press, September 18, 2018) agrees. “I have not witnessed blood sugar control or management with CBD alone,” Konieczny told On Track Diabetes in an interview. “CBD clearly will help with the inflammation that accompanies diabetes and in that way [can be] a very helpful addition.”

It may also ease the pain of peripheral neuropathy, she says. But people with diabetes shouldn’t expect it to lower their glucose levels or their A1Cs. “I have never seen anyone stop needing their diabetes medications because they started using CBD or cannabis,” she says.

What Research Really Says

Unlike marijuana, the compound cannabidiol won’t get you high even though it’s derived from cannabis. But product sales and interest in CBD are hitting new heights. In June, the FDA approved Epidiolex (cannabidiol), the nation’s first drug derived from marijuana, for two rare forms of epilepsy—Lennox-Gastaut syndrome and Dravet syndrome 5 .

Over-the-counter and Internet sales of non-prescription CBD oil are expected to rise from $190 million in 2017 to $626 million by 2022 according to the Hemp Business Journal’s State of Hemp 2018 report 6 .

CBD is also turning up in everything from beauty products like lip balm and mascara to sodas, alcohol, and infused waters.

CBD’s got real potential in a wide variety of health conditions. There are currently more than 75 human studies of cannabidiol that are active, recruiting volunteers or in planning stages for conditions ranging from seizures to anxiety, post-traumatic stress disorder, Crohn’s disease, heart failure, Parkinson’s disease, bipolar depression, and cocaine dependence .7

Not one focuses on diabetes.

In fact, one of the only studies to ever look directly at the effects of cannabidiol on blood sugar and insulin levels in people with diabetes found no benefits at all. 8 Published in the journal Diabetes Care in October of 2016, this British study compared the effects of CBD and another cannabis compound (tetrahydrocannabivarin (THCV)) on blood sugar, insulin sensitivity, HDL cholesterol and other markers in 62 people with type 2 diabetes.

They took one of the compounds, or a combination of the two, daily for 13 weeks. The result: While THCV reduced blood sugar a little, CBD didn’t affect blood sugar levels. (CBD did seem to cause small changes in resistin, a protein that boosts inflammation and may be involved in insulin resistance; and glucose-dependent insulinotropic peptide hormone that stimulates insulin release.) “But there were no detectable metabolic effects,” the researchers concluded.

Related

  • Considering Pot for Pain?
  • Diabetes Medications & Heart Disease: Are You Getting the Care You Need?

The research had been supported by the UK drug company GW Pharmaceuticals, which went on to develop Epidiolex for seizure disorders. In April 2017 the company, which specializes in the development of cannabidiol-based medicines, announced that it was no longer researching its CBD compound for diabetes “due to negative data in diabetes.” 9

So what about all the research cited online suggesting blood sugar benefits? Some mis-state the results of the UK study. All link readers to small studies in animals, with results that have not been tested or not been replicated in people. Many laud work done in Israel a decade ago, when 68% of diabetes-prone mice who got CBD didn’t develop blood sugar problems. 10

What the FDA Says

Between 2015 and 2018, the US Food and Drug Administration sent warning letters to companies that marketed CBD products, over claims and testimonials that oils and other products could treat diabetes and other conditions—including cancer. The FDA also warned that in some cases, lab tests showed that the products contained no CBD.

You won’t find those unfounded treatment claims and miracle-cure testimonials on product websites anymore. But they are turning up more and more frequently on other websites. When the drug Epidiolex won approval in the US this summer, FDA Commissioner Scott Gottlieb, MD, warned consumers about the dangers this could pose. “The promotion and use of these unapproved products may keep some patients from accessing appropriate, recognized therapies to treat serious and even fatal diseases,” Dr. Gottlieb said in a statement.

“The FDA has taken recent actions against companies distributing unapproved CBD products. These products have been marketed in a variety of formulations, such as oil drops, capsules, syrups, teas, and topical lotions and creams. These companies have claimed that various CBD products could be used to treat or cure serious diseases such as cancer with no scientific evidence to support such claims. We’re especially concerned when these products are marketed for serious or life-threatening diseases, where the illegal promotion of an unproven compound could discourage a patient from seeking other therapies that have proven benefits.” 11

Dr. Bhatia says that while CBD oil can have an important role to play in medicine, its difficult finding unbiased information. “The controversy surrounding cannabis has to do with the tug of war between medical purpose and recreational use—not to mention big money,” she notes on her website. “I think for now it is best to try it for the conditions recommended. For example—epilepsy, pain, Crohn’s disease or Inflammatory Bowel Disease,” she told On Track Diabetes.

“We are using CBD without THC for chronic inflammatory conditions as well.” If you still want to give it a try, do your homework to determine if it’s safe for you. And Dr. Bhatia says you should look for proof it’s helping—and not change your existing medications. “Try it for three months,” she says. “But don’t cut back on diabetes medications.”

OnTrack Diabetes investigates claims that cannabis can be beneficial for people with diabetes Part 1 in a series of three reports.