Diabetes is fast becoming a modern day epidemic. Over the last 30 years the number of sufferers have quadrupled to approximately 422 million worldwide. But studies suggest that the cannabis plant could ameliorate some of the associated symptoms, such as regulating blood sugar levels, reducing neuropathic pain and limiting cardiovascular damage.
What is diabetes?
Diabetes relates to the body’s ability to produce and/or use insulin efficiently. Insulin is a hormone needed to convert glucose into energy. Without it sugar builds up in the blood, which if left untreated has dangerous consequences. Why this happens tells us whether it is diabetes type 1 or 2.
Type 1 Diabetes occurs when the pancreas is unable to produce insulin. It is considered a type of autoimmune disease because the body has destroyed its own insulin producing cells. The disease usually begins in childhood, with sufferers depending on insulin injections to control blood sugar levels for the rest of their lives.
Type 2 diabetes is by far the most common form of the disease. It is referred to as insulin resistance and is when the pancreas doesn’t produce enough insulin or the body’s cells don’t react to insulin as they should. High glucose levels in the blood are the consequence, sharing the same health risks as type 1: vision loss or blindness, renal failure, cardiovascular disease and strokes.
Type 2 diabetes is generally adult onset and is associated with obesity, although a study has suggested that it too could be rooted in a misdirected immune response, finding that subjects with insulin resistance produced antibodies against some of their own proteins.
In the initial stages type 2 diabetes can be regulated by dietary changes and exercise, but often eventually requires medication to control glucose levels.
Lying at the heart of both illnesses is an intricate dance between the immune system, excessive inflammation and oxidative stress. All of which scientists believe can be targeted by compounds found within the cannabis plant called cannabinoids.
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Can cannabis help Type 1 Diabetes?
In the case of type 1 diabetes , no amount of cannabis is going to make up for a pancreas that isn’t producing insulin. But it can researchers believe, go some way towards slowing the disease in its early stages, due to the plant’s ability to modulate the immune system and bring into line excess inflammation.
A study using Cannabidiol (CBD) administered to mice with early stage autoimmune diabetes, found the cannabinoid “ameliorates the manifestations of the disease. Diabetes was diagnosed in only 32% of the mice in the CBD-treated group, compared to 86% and 100% in the emulsifier-treated and untreated groups, respectively.” Not only that but pro-inflammatory markers were reduced, the anti-inflammatory cytokine IL-10 significantly elevated, and there were more intact islets in the pancreas, compared to the control group. All of which suggesting that CBD, if administered early enough, “could possibly be used as a therapeutic agent for treatment of type 1 diabetes.”
Another study this time using the psychoactive cannabinoid THC on mice with autoimmune diabetes, found that its administration lowered levels of hyperglycemia, reduced inflammation markers and was accompanied by a decrease in the loss of pancreatic insulin.
So far, no clinical trials testing cannabinoids on human subjects with type 1 diabetes have taken place. In contrast, Type 2 Diabetes has seen research move from the laboratory to humans, with some promising results.
Type 2 Diabetes – Clinical trials show potential for cannabinoids
The British pharmaceutical company specializing in cannabinoid therapeutics GW Pharma, has made avenues into trialling cannabinoids for insulin resistant diabetes. The most successful so far being a randomized, double-blind, placebo-controlled study testing CBD and THCV on 62 non-insulin treated Diabetes type 2 patients. THCV proved the real superstar of the piece significantly decreasing fasting plasma glucose and showing improved pancreatic β-cell function. The study concluded that THCV “could represent a new therapeutic agent in glycemic control in subjects with type 2 diabetes.”
Indeed, a five year study conducted in the US on the effects of cannabis on fasting insulin and insulin resistance showed that regular cannabis consumers have 16% lower fasting insulin levels and 17% lower levels of insulin resistance than respondents who’d never used cannabis. The scientists also noted a smaller waist circumference in regular cannabis users; all of which suggests that the cannabis plant does have some kind of impact on the body’s metabolic system.
Link between overeating and chronic inflammation
But to really shed any light on why cannabinoids might be a potential therapeutic target for Type 2 Diabetes, we should take a brief look at some of the factors lying behind the disease.
Obesity is commonly stated as a cause of insulin resistant diabetes, but the findings of some Norwegian scientists help explain why this might be. They believe overeating stimulates the immune response, creating excessive inflammation in the body.
The researchers put this down to oxidative stress brought on by damage to the cells’ mitochondria, which are the body’s powerhouses converting glucose to energy.
“When the cells receive excessive energy, the system starts to falter, and the engine may stall. Too much fatty acid causes an oxidative stress in the cells. We believe that long-term stress on the mitochondria may cause metaflammation. A metaflammation is a low-grade chronic inflammation over many years, and unfortunately it’s a condition that’s difficult to detect,” says Yndestad, one of the researchers.
Inflammation is considered a precursor to Diabetes type 2, but is also very much part and parcel of the disease. According to webmd.com, “as type 2 diabetes starts to develop, the body becomes less sensitive to insulin and the resulting insulin resistance also leads to inflammation. A vicious cycle can result, with more inflammation causing more insulin resistance and vice versa.”
CBD reduces inflammation in diabetes studies
The cannabinoid Cannabidiol (CBD) has been shown to be an anti-inflammatory agent and in a study on non-obese diabetic mice there were reduced plasma levels of pro-inflammatory cytokines and increased levels of anti-inflammatory TH-2 associated cytokines, supporting the idea that CBD regulates excessive inflammation. Not only that but the administration of CBD was seen to reduce the incidence of diabetes in the rodent subjects from an incidence of 86% in non-treated control mice to an incidence of 30% in CBD-treated mice.
Could it be that CBD’s anti-inflammatory action was instrumental in reducing the level of diabetes in the trial?
Diabetes complications – oxidative stress a factor
Another potential therapeutic target for cannabinoids and diabetes is protecting against the damage caused by oxidative stress. Often going hand in hand with chronic inflammation, it is when there is an imbalance between the production of free radicals and the ability of the body to counteract their harmful effects with antioxidants.
There is a direct link between diabetes and oxidative stress as hyperglycemia (high blood sugar levels) promotes the formation of free radicals, resulting in complications such as cardiovascular disease, strokes, renal failure, neuropathy and eye diseases like retinopathy.
In the paper ‘Antioxidants and Diabetes’ published in the Indian Journal of Endocrinology and Metabolism, it outlines how both Diabetes type 1 and 2 are “accompanied by increased formation of free radicals and decreased antioxidant capacity, leading to oxidative damage of cell components,” and that “hyperglycemia-induced generation of free radicals at the mitochondrial level is thought to be the major driver of the vicious cycle of oxidative stress in diabetes.”
Cannabinoids are powerful antioxidants
When the body can’t produce sufficient antioxidants of its own, the standard course of action is to find them in external sources such as fruit, vegetables, grains and oily fish. This could be where cannabis comes to the fore, as studies have found it to be a more powerful antioxidant than Vitamins C and E. Indeed the US Federal Government even holds a patent for cannabinoids as antioxidants.
But an element of caution should be noted, as in general the effectiveness of antioxidant therapy remains yet to be fully proven. However it could explain why in many anecdotal cases people claim to have prevented some of the more serious complications associated with diabetes thanks to regular cannabis use.
But what about if you’re already experiencing some of the health conditions associated with diabetes. Can cannabinoids help there too?
Can cannabis relieve neuropathy?
Well, turns out that certain scientific studies suggest they can. Let’s start by looking at neuropathy.
Classified as a type of nerve damage with symptoms such as pain, tingling and numbness in the body’s extremities, it affects up to 70% of diabetes patients.
Preclinical studies testing CBD on diabetes induced neuropathy in rats, found administration of the cannabinoid “significantly relieved” painful responses to non-painful stimuli and restored normal perception of pain. Protection of the liver against oxidative stress was also noted, as well as the return to normal of nerve growth factors.
Clinical studies on humans have delivered varying results when it comes to neuropathy. A 2009 studyconducted by GW Pharma testing diabetic neuropathy patients with Sativex, a cannabis based drug developed for Multiple Sclerosis with a 1:1 THC/CBD ratio, found that the drug was of little more benefit than the placebo.
However, a 2015 study administering THC to diabetic patients with neuropathy of the feet found a “dose-dependent reduction in diabetic peripheral neuropathy pain.”
CBD – a protection against diabetic blindness?
Another common condition affecting long term diabetic patients is retinopathy – the damage to the small blood vessels behind the eye that can eventually lead to the detachment of the retina. It is the leading cause of acquired blindness in developed countries and is caused by the high glucose levels, pro-inflammatory immune response, and oxidative stress associated with the disease.
CBD once again shows promise, with a study carried out on rodent models at the Medical College of Georgia, finding the cannabinoid protected the eye from the accumulation of leaky blood vessels.
Dr Liou the lead scientist explained, “What we believe cannabidiol does is go in here as an antioxidant to neutralize the toxic superoxides. Number two, it inhibits the self-destructive system and allows the self-produced endogenous cannabinoids to stay there longer by inhibiting the enzyme that destroys them.”
As yet, there are no clinical trials on humans to support these findings.
So as ever, there is no conclusive evidence that cannabis and its constituents can treat diabetes. But, the fact that cannabinoids such as CBD are anti-inflammatory, help to regulate the immune response, and are powerful antioxidants, suggest they could show potential for slowing the onset of the disease and its many serious health complications.
Are you diabetic and regularly use cannabis or CBD? We’d love to hear about your experiences in the comments section below.