Cbd oil for diabetic neuropathy

The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities

Background: Peripheral neuropathy can significantly impact the quality of life for those who are affected, as therapies from the current treatment algorithm often fail to deliver adequate symptom relief. There has, however, been an increasing body of evidence for the use of cannabinoids in the treatment of chronic, noncancer pain. The efficacy of a topically delivered cannabidiol (CBD) oil in the management of neuropathic pain was examined in this four-week, randomized and placebocontrolled trial.

Methods: In total, 29 patients with symptomatic peripheral neuropathy were recruited and enrolled. 15 patients were randomized to the CBD group with the treatment product containing 250 mg CBD/3 fl. oz, and 14 patients were randomized to the placebo group. After four weeks, the placebo group was allowed to crossover into the treatment group. The Neuropathic Pain Scale (NPS) was administered biweekly to assess the mean change from baseline to the end of the treatment period.

Results: The study population included 62.1% males and 37.9% females with a mean age of 68 years. There was a statistically significant reduction in intense pain, sharp pain, cold and itchy sensations in the CBD group when compared to the placebo group. No adverse events were reported in this study.

Conclusion: Our findings demonstrate that the transdermal application of CBD oil can achieve significant improvement in pain and other disturbing sensations in patients with peripheral neuropathy. The treatment product was well tolerated and may provide a more effective alternative compared to other current therapies in the treatment of peripheral neuropathy.

Keywords: CBD; cannabis sativa; diabetic neuropathy; hemp; nerve pain; review..

Copyright© Bentham Science Publishers; For any queries, please email at [email protected]

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Is CBD oil effective for diabetic neuropathy?

Diabetic neuropathy defines a form of nerve damage that occurs because blood glucose levels have shot. There are at least four types of diabetic neuropathy affecting legs, feet, thighs, buttocks, arms, and hands, and can even extend to sensitive organs like the stomach, eye, and the heart. When not controlled, diabetic neuropathy may result in blindness and heart diseases. Consequently, people are worried about CBD oil for diabetic neuropathy(if the cannabinoid can be effective for this condition). No clinical trials have been done to claim with sufficient evidence that CBD oil can be effective for diabetic neuropathy. However, initial research claims that CBD oil may help manage the pain and inflammation that result from diabetic neuropathy, but such is limited since it majorly focuses on animal models or cultured nerve cells while not generally supported by advanced scientific studies. CBD is not marketed or recommended for curing diabetic neuropathy.

The Background Information of CBD Oil

CBD oil or cannabidiol oil is a hemp extract or one of the active compounds called cannabinoids present in the cannabis sativa plant. Unlike THC, that’s also closely studied, CBD oil is not linked to the ‘high’ effect and may not result in psychoactive effects, which is why it is marketed to help with just about anything in the name of a wellness challenge. CBD oil is available as isolate (99.9% or more pure CBD with no other cannabinoids), full-spectrum (CBD and other cannabinoids such as THC, CBG, CBT, and CBN present), and broad-spectrum formulations with all cannabinoids but THC. The last two CBD oil types are linked to the full entourage effect, especially because they have more than one cannabinoid. There are many forms of CBD oil, including topicals (serums, sticks, patches, lotions, massage oils, bath bombs, and more), edibles (gummies, lozenges, chocolates, brownies, and more), softgels or capsules, oils, and tinctures, smokables (hemp flower), and vapes (vape pens, cartridges, and more), and most of these products are easily accessible in stores, shops, and health/beauty stores.

Causes, Types and Consequences of Diabetic Neuropathy

Diabetic neuropathy refers to the nerve damage that occurs when nerves in various body parts, primarily the lower extremities, are damaged because of elevated blood glucose levels. There are at least four types of diabetic neuropathy, including;

Mononeuropathy

Affects one nerve in any part of the body but majors on the legs and feet, causing dull numbing or sharp shooting pains.

Peripheral neuropathy

Affects the lower body extremities, including the legs and feet, causing sharp shooting pains, permanent numbness, or dull numbing pains.

Diabetic amyotrophy

Usually affects diabetic type II patients, severely impacting their legs, feet, thighs, and buttocks. Common symptoms of this form of diabetic neuropathy include sudden weight loss, swelling, and amyotrophic leg and feet muscles.

Autonomic neuropathy

It’s a severe form of diabetic neuropathy extending to critical organs like the heart, eyes, and stomach. Because it results in severe nerve pains in the affected regions, it is linked to increased heart rates, heart disease, blindness, erectile dysfunction, and more.

Is CBD Oil Effective for Diabetic Neuropathy?

Since conventional medication prescribed for managing diabetic neuropathy may not work for many. According to a study by Wallace, et al., (2015).,CBD oil may make an effective treatment or managing option for diabetic neuropathy. Currently, no clinical trials have been conducted to show that CBD oil can help with diabetic neuropathy. Even though some initial studies claim that CBD oil may help with diabetic neuropathy pains, such are not advanced and are limited in the sense that they majorly focus on cultures, nerve cells or animal models and are also not backed by recent advanced scientific studies.

CBD Oil for Managing Diabetic Neuropathy Pains

Although scientific studies do not support the use of CBD oil for managing diabetic neuropathy, some people are using it anyway. In fact, anecdotal evidence claims that some diabetic neuropathy patients have found relief in using CBD oil for managing diabetic pain. Still, the FDA has not approved CBD for pain management, whether from diabetic neuropathy or other causes. A 2012 study published in the Journal of Experimental Medicine observed that when CBD was administered on rat’s nerve cells, there was a considerable pain reduction, suggesting that CBD oil may have some nociceptive (pain) regulatory roles. Many people bank on CBD oil to help them manage their neuropathic pain. Still, study does not recommend the cannabinoid or its products for pain management, especially because of the many knowledge gaps surrounding CBD oil studies.

CBD Oil for Anti-inflammatory Effects

In most cases, pain stems from inflammation, and diabetic neuropathy is no exception. The condition comes with inflammation, which exacerbates pain in the affected areas, whether joints, hips, buttocks, legs, eyes or any body parts. Yet, one remarkable study by Cabrera, et al., (2021), it suggests that CBD oil may make a good inflammatory remedy. For instance, one study applied CBD oil gel on rats with arthritic inflammation and recorded reduced inflammatory markers. CBD oil proponents market CBD oil products for managing inflammatory effects and pains from diabetic neuropathy. However, until the uncertainties surrounding CBD oil are cleared, studies do not recommend CBD oil for any medical use, including managing diabetic neuropathy inflammation and pain.

Should You Use CBD Oil for Diabetic Neuropathy?

In view of the above, no clinical trials or scientific studies support CBD oil for neuropathic pain, even from diabetes. Besides, the FDA has not approved CBD oil for managing diabetic neuropathy, and using the cannabinoid anyway is a risky approach. Still, should one choose to take CBD oil for diabetic neuropathy, consult the doctor to know what dosages you should take or how to use the products.

Conclusion

Diabetic neuropathy is a form of nerve damage caused by elevated blood glucose levels. It majorly affects the lower extremities like legs and feet but may extend to the heart and other critical organs. While some initial studies claim that CBD oil may be effective for diabetic neuropathy, no scientific studies back up the claim. As such, studies do not recommend CBD oil for this condition, and whoever chooses to go that route should consult a doctor before doing so.

References

Wallace, M. S., Marcotte, T. D., Umlauf, A., Gouaux, B., & Atkinson, J. H. (2015). Efficacy Of Inhaled Cannabis On Painful Diabetic Neuropathy. The Journal Of Pain, 16(7), 616-627. Cabrera, C. L. R., Keir-Rudman, S., Horniman, N., Clarkson, N., & Page, C. (2021). The Anti-Inflammatory Effects Of Cannabidiol And Cannabigerol Alone, And In Combination. Pulmonary Pharmacology & Therapeutics, 69, 102047.

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.

CBD may help relieve symptoms that can contribute to high blood sugar in type 2 diabetes. Everyday Health

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.