How CBD may help manage symptoms
by Kristin Easterling

In 2018, 34.2 million Americans, or 10.5% of the population, had diabetes, according to the American Diabetes Association (ADA). The ADA estimates that 7.3 million of those experiencing symptoms are undiagnosed. Managing diabetes, especially Type 2 diabetes, can be a struggle for many. And while not all people living with Type 2 diabetes require insulin therapy, many of the medications to manage the condition can have adverse drug interactions that cause dangerously low blood sugar.

There may be a new alternative on the market in some cases: cannabidiol or CBD oil. The hemp-derived oil is available in a variety of delivery methods, and animal studies have shown that it can help with some of the struggles that come with diabetes, from glycemic control to dry, sensitive skin.

Alex Capano, a doctor of nursing practice and chief science officer for Ananda Health and Ananda Professional, shared some of the research around CBD and diabetes. Ananda Professional is a Kentucky-based company providing CBD oils, edibles and more for humans and animals.

HOMECARE: Do both Type 1 and Type 2 diabetes benefit from CBD?

CAPANO: Yes, but in different ways. CBD can help both Type 1 and Type 2 diabetics prevent or manage neuropathic pain and improve sleep disturbances or anxiety that may come with the disease. CBD reduces systemic inflammation, which is important for all diabetic patients, but we see different opportunities in Type 2 versus Type 1. For example, animal trials have shown that CBD improves pancreas function and insulin resistance. And in Type 1, the pancreas isn’t producing insulin at all. Now, there are some subsets of Type 1 where it’s still producing a little bit, but generally, if you have Type 1 diabetes, you’re just not producing insulin. And with Type 2 diabetes, you’re not responding to the insulin you produce. So you want to protect the pancreas in both states. For Type 2, you want to help the pancreas produce insulin and respond to it as much as possible, for as long as possible. That’s where we see a benefit from CBD.

HOMECARE: How might CBD help with glycemic control?

CAPANO: We’re not sure about the mechanism in humans, but again, animal trials have shown a reduction in blood glucose when CBD is used regularly. In theory, it should also help humans, but we are still looking for that data.

HOMECARE: What is hemp protein and what components of hemp protein help in nutrition?

CAPANO: Hemp protein comes from the seeds of the plant and doesn’t contain any CBD or THC. You can either eat the seeds or it comes ground up. And then I use it in oil form. It’s a little nutty in flavor.

There’s a specific protein called edestin that’s only found in hemp. It is a globular protein, so it’s similar to the immunoglobulins that we make in our bodies that are really good for us and create antibodies. And because it’s so similar, it is really easily digested and is considered to have a comprehensive amino acid profile, which they call the backbone of cells. Edestin is really unique and, again, only found in the hemp plant. If you’re trying to have the healthiest immune system possible, you suddenly want all those immunoglobulins, you want to be able to produce antibodies, and edestin is something that certainly will help optimize your own immune system.

Beyond that, hemp also has a good amount of glutamic acid. That’s a neurotransmitter that helps deal with stress, anxiety, any sort of negative psychological symptoms. Those two proteins—the glutamic acid and the edestin—are unique but abundant in hemp proteins. So you get something different from this protein that’s easily digestible, is plant-based, is really sustainable to grow and then also has the great omega fatty acids as well.

HOMECARE: How can topical CBD help with skin protection and with neuropathic pain?

CAPANO: In a couple of different ways. When you use a topical CBD product, it is going to deliver CBD to the outer layers of the skin, which has quite a lot of receptors to receive that CBD. [The skin] is really like a magnet for CBD, but topical application doesn’t really have any systemic take-up. So you’ll get that localized relief, that local anti-inflammatory effect, a little bit of that local antinociceptive effect. And what I meant by antinociceptive is that it reduces your perception of pain. If you take an antinociceptive, it doesn’t actually reduce the [inflammation at the] source of the injury, but it makes you not feel it so much. CBD does both.

You’re treating the actual underlying cause of the inflammation, but you’re also reducing your perception of the pain through that antinociceptive effect. And then, if CBD is coupled with a topical product with something like hemp seed oil or other highly emollient carriers, that is going to moisturize the skin and reinforce the protective function that the skin has, and it reduces flaking, reduces dryness and reduces risk of breakdown. CBD does that as well, but I wouldn’t just put only CBD on the skin because it is pretty sticky on its own. And then, CBD—or at least we know this about Ananda’s CBD extract specifically because we did test it through a third-party lab—is antimicrobial. So you’re getting rich, deep moisturization and relief. But you’re still getting that antimicrobial effect on your skin and that protection from infection.

HOMECARE: Is there a certain type of CBD that’s better for people living with diabetes? Or are there any that they should avoid?

CAPANO: You want a CBD product that is what we call full spectrum. Full spectrum that means it has that trace amount of THC in it that’s found in a hemp plant and has other cannabinoids, terpenes and flavonoids. The reason that matters is when you use a full spectrum product, you can use less and actually get a better therapeutic outcome. And it’s also about finding a quality product. You want something that has been tested for potency—so you’re getting what you pay for—and also has been tested for purity, so you’re not putting anything in your body that could be damaging. The hemp plant actually leaches things like heavy metals from the soil. Sometimes people use pesticides on plants, or they blow over from another farm, and solvents are used to manufacture these products. You need to make sure that the end product has no pesticides, no heavy metals, no residual solvents. Quality and transparency are really the important parts.

And then another thing that’s particularly important for people with diabetes is the carrier oil. CBD, the actual extract, is really sticky, which requires it to be dissolved in some sort of carrier. Ideally that carrier oil is going to be something that is rich in omega-3 fatty acids, is a healthy oil and is not in something that is full of sugar and artificial flavoring. If the carrier is full of sugar, it’s just going to make their blood sugar spike. That would be something to consider for this population, but it’s really just about a quality product.

HOMECARE: How often should CBD be administered for diabetes?

CAPANO: At least every day. These positive outcomes that I mentioned, it’s not like
they happen immediately. Certainly, someone can get improvement in their neuropathic pain from their first dose. To prevent further injury, to maybe even help repair that injury, you want to be using it every day. And the studies in humans that have shown the best outcomes are using it two to three times a day.

You are not going to overdose on CBD; it’s well-established as safe. And what we see in the research is (that you want to take) 20-45 milligrams at least twice a day, ideally three times a day if you can tolerate it. We are doing a phase two clinical trial right now looking at neuropathic pain and we are using three-times-a-day dosing.

Kristin Easterling is the managing editor of HomeCare magazine.