Almost half a billion people are living with diabetes worldwide, and the prevalence is projected to increase to 25% in 2030 and 51% in 2045 . A growing body of scientific evidence links endocannabinoid system imbalances to metabolic regulation and glycemic control, generating increased interest in the endocannabinoid system as a potential drug development target for diabetes . Additionally, the endocannabinoid system modulates pathophysiological processes related to the development of diabetic complications, such as retinopathy, cardiovascular disease, nephropathy, and peripheral neuropathy. Preliminary evidence shows that the antioxidant and anti-inflammatory properties of cannabinoids, such as cannabidiol (CBD) and tetrahydrocannabivarin (THCV), may be beneficial in the treatment of diabetes and its complications .
Diabetes and the Endocannabinoid System
Cannabinoid receptor 1 (CB1R) signaling plays a role in the progression of diabetes and its complications, suggesting that the endocannabinoid system may be a promising therapeutic target. Patients with type 2 diabetes have higher serum levels of endocannabinoids anandamide (N-arachidonoylethanolamine; AEA) and 2-arachidonoylglycerol (2-AG) compared to healthy volunteers. CB1R receptors are found on pancreatic islet cells, but the exact role in diabetes pathogenesis is unclear .
Rimonabant is a synthetic CB1R antagonist that showed substantial potential for the treatment of diabetes, but it was removed from the market in 2008 due to severe psychiatric side effects, including anxiety, depression, and suicidality , . Evidence from rimonabant trials showed that CB1R modulation led to significant reductions in body weight, waist circumference, and HbA1c in patients with type 2 diabetes .
Phytocannabinoids and Diabetes
Phytocannabinoids such as CBD and THCV are produced naturally by cannabis plants. They exhibit antagonistic activity on CB1R signaling but do not appear to have the psychiatric risks associated with rimonabant. In addition to these phytocannabinoids, hemp or cannabis plants produce several other cannabinoids, terpenes, and flavonoids with therapeutic potential in the treatment of diabetes.
A 13-week study of 62 people with type 2 diabetes randomized participants to five different treatment groups: CBD (100 mg twice daily), THCV (5 mg twice daily), a 1:1 ratio of CBD and THCV (CBD 5mg and THCV 5 mg twice daily), a 20:1 ratio of CBD and THCV (CBD 100 mg and THCV 5 mg twice daily), or placebo. Compared with placebo, THCV significantly decreased fasting plasma glucose and improved pancreatic beta cell function. CBD decreased resistin, a hormone that links obesity to diabetes , and increased glucose-dependent insulinotropic peptide, a hormone that stimulates insulin secretion in response to nutrient stimulation . However, CBD did not cause any improvement in glycemic control. The combination treatments of CBD and THCV did not result in a significant effect compared to placebo . The results show the potential and need for further research on cannabinoids for the treatment of diabetes.
CBD for Diabetic Complications
CBD has shown several desirable effects related to the treatment of diabetes in vitro and animal studies, such as:
- anti-inflammatory and antioxidant properties 
- reduced neurotoxicity and inflammation 
- modulation of cardiovascular response to stress 
- increased HDL and reduced total cholesterol 
Diabetic complications are a significant cause of increased morbidity and mortality in people with diabetes. Early evidence shows promising therapeutic potential of CBD for the treatment of diabetic complications.
Diabetes is the leading cause of preventable blindness in the adult working population . Early evidence shows that CBD has potential in the treatment of diabetic retinopathy through its anti-inflammatory and antioxidant properties .
- Cardiovascular Disease
Diabetes is an independent risk factor for cardiovascular disease, including coronary artery disease, myocardial infarction, hypertension, peripheral vascular disease, and stroke . Evidence from animal studies shows that CBD may modulate cardiovascular responses to stress . Endocannabinoid receptors are present on cardiovascular endothelial cells, and the endocannabinoid system likely plays a role in diabetes-related cardiovascular complications , .
Diabetes is the leading cause of end stage renal disease worldwide . Early evidence from in vitro and in vivo studies suggests endocannabinoid system modulation in the pathogenesis of renal failure in diabetes .
- Peripheral Neuropathy
Diabetic peripheral neuropathy affects nearly 50% of adults with diabetes, and is associated with substantial consequences such as pain, skin ulcers, and limb amputation . Preclinical evidence and animal studies have shown the potential of endocannabinoid system targets in neuropathic pain. A small randomized, double-blind, placebo-controlled crossover trial in 16 patients with painful diabetic peripheral neuropathy designed to assess the short-term efficacy and tolerability of inhaled cannabis found a dose-dependent reduction in pain intensity .
A growing body of evidence links endocannabinoid system modulation to metabolic regulation and glycemic control, suggesting substantial therapeutic potential for cannabinoids in the treatment of diabetes and its complications. While preliminary research is promising, clinicians need further research, education, and guidance to create individualized treatment plans. Consumers should select full-spectrum CBD oil products from reputable sources with verifiable lab testing and rigorous quality control practices.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. We encourage you to speak with your medical provider to determine if a full-spectrum CBD oil is right for you.
About Blue Gem Hemp
Blue Gem® Hemp proudly makes premium Full-Spectrum CBD Oil. Two simple ingredients: organic, American-grown hemp and medium-chain triglyceride (MCT) oil, designed to elevate your self-care. Your Wellness! Our Passion!
By Simi Burn, PharmD
February 23, 2022
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