Ten Questions Answered on CBD Oil and Diabetes
What is CBD Oil and How Do You Use It?
Cannabidiol, better known as CBD oil, is extracted from the cannabis plant, and diluted with a “carrier oil” like coconut or hemp seed oil.
CBD is one of the many chemicals known as “cannabinoids” found in the cannabis plant, that appear to bind to receptors in the brain to produce certain effects. But this one does not contain the best-known cannabinoid, tetrahydrocannabinol (THC), which causes the “high” people feel after using marijuana.
CBD oil does not produce a high, but it is credited with alleviating symptoms of a number of ailments, including chronic pain, anxiety and depression.
It should not be smoked. Rather, it is edible and can be added to food. It can also be used topically on the skin. But it’s most often taken in pure oil form by simply placing the desired quantity of drops under your tongue using the dropper, and holding it there for a minimum of 60 seconds — to allow for absorption via the blood vessels. Once 60 seconds has passed, you swallow the CBD oil.
How much to take depends on the condition you’re hoping to treat, but generally runs between 2.5 – 20mg per day, according to most product recommendations.
Diabetes is an inflammatory condition and CBD does have anti-inflammatory properties. In research, CBD has shown promise in reducing insulin resistance and moderating blood sugars for people with type 2 not taking insulin.
ore about CBD oil and diabetes, we were immediately referred to Emily Kyle, a Registered Dietitian Nutritionist (RDN) and Holistic Cannabis Practitioner based in upstate New York. While not a diabetes expert per se, Kyle has become well-known among healthcare providers as an expert on the overall health effects of cannabis.
We asked her five key questions on CBD oil as it relates to diabetes:
DM) Are there any concerns about using it when you have diabetes?
EK) Just like any other over-the-counter supplement or medication, there are obvious concerns when using CBD oil if you have type 1, type 2, or gestational diabetes. Concerns can range from the type and quality of the product being used to various potential side effects that may occur as a result.
The biggest concern lies in the possibility of a cannabinoid-drug interaction for those who are taking prescribed medication and/or insulin to manage their diabetes. Researchers believe that “it is possible that the endocannabinoid system buffers insulin sensitivity rather than strictly inhibiting it.”
There’s a lack of clinical evidence to provide guidelines one way or another of the safety and efficacy of the cannabinoid CBD itself. Additionally, CBD is just one of hundreds of cannabinoids, and it is unclear whether other cannabinoids such as CBN or THC, which could be found within a CBD oil product, may have a direct impact on those with diabetes as well.
Does it have any direct effects on blood sugar?
Unfortunately, clinical studies in humans on the direct effect of CBD oil on blood sugar is lacking, likely due to the illegal status of marijuana which is currently seen as a schedule 1 drugTrusted Source in the eyes of the Federal Government.
What we do know is that the body’s endocannabinoid system plays an integral part in the regulation of energy metabolism, which is important to know for those who are living with diabetes. Emerging data suggests that “the endocannabinoid system sets the sensitivity of the insulin response in adipocytes.” This means that the endocannabinoid system plays an important role in how the body responds to insulin, increasing or decreasing insulin sensitivity. This is critically important for those who are taking insulin because it could mean that their blood sugars could rise or fall unexpectedly, making tight control more difficult to achieve.
Anecdotally, I have had clients who exhibit completely different response reactions to CBD oil use. One client told me it dramatically decreased their blood sugar within a matter of minutes, which is potentially very dangerous. Other clients notice no effect on blood sugar at all. This is attributed to the uniqueness of each person’s endocannabinoid system and their personal endocannabinoid tone.
What’s the best CBD oil to choose if you have diabetes?
The best CBD oil to choose if you have diabetes is one that has been produced by a reputable company that has also been verified by a third-party lab testing company to ensure that what is stated on the label is accurate and true. At this time CBD is an unregulated market and several studies have shown that several CBD oil products are misleading to consumers by either not containing what was promised, or containing additional ingredients that were not disclosed.
Additionally, I always recommend individuals stay away from and added ingredients, artificial flavorings, artificial dyes, added sugars or other ingredients such as melatonin.
Are CBD gummies containing sugar an option for PWDs, or do you know of any brands with no carb effect?
Regardless of whether you have diabetes or not, if we are truly using CBD for health promoting purposes and/or preventative wellness, it is counter-intuitive to combine that with refined sugar, artificial dyes, and artificial flavorings.
Instead, I encourage people to make their own CBD gummies at home with whole-food ingredients such as fruit and vegetable purees and quality CBD oil extract or concentrate.
What should PWDs consider when deciding whether or not to try CBD oil?
If you are unsure about how to begin to use CBD oil with a condition like diabetes and want to do so safely, consider reaching out to a Holistic Cannabis Practitioner or other trained healthcare professional for cannabis counseling
Using CBD Oil with Type 1 Diabetes
nosed with type 1 diabetes as a teenager in 2006. He runs a nonprofit called “Diabetics Doing Things.” In recent years, he’s become a proponent for use of CBD oil.
We also asked him five key questions on the topic:
DM) How do you personally use CBD oil?
RH) I actually do both, but my primary form is by oral capsules. I usually take one 30mg pill every morning or I mix 30mg of tincture (liquid) into my coffee in the morning. I’ve used it as a topical cream as well, but mostly on sore joints. I find that I get more of a whole body effect by taking CBD orally.
What are the actual effects on your body?
Good question! The best example I can give is that I’m a very deep sleeper, and tend to have a tough time getting going in the mornings. CBD keeps me more balanced, meaning I can wake up easier, get warmed up for sports/fitness easier, recover from workouts quicker, get ready for bed easier, etc. In terms of measurable effects, I would say my soreness is reduced after workouts, I have more time in deep sleep on my sleep tracker, and I’m in a better mood as a result of both.
Have you noticed any impact on your diabetes specifically?
As far as I can tell, I haven’t seen any direct impact on my blood sugars as a result of taking CBD as it is available over the counter or online. That’s just my experience. However, the ability to get more exercise without pain and get better sleep have indirect impact on my diabetes, so I think that tips the scales in the favor of ‘CBD does impact my diabetes positively.’
Does your endocrinologist or diabetes educator have any thoughts on your use of CBD oil?
My endo sort of rolls her eyes at me because of my pursuit to be a hyper-optimized human, so to her CBD is just another of the latest and greatest health trends that I’m into. She of course asked me to be mindful when I started taking it, and was happy to hear of my positive outcomes regarding holistic health and wellness even though I told her my diabetes had not been directly impacted.
In your opinion, what’s the best CBD oil for a person with diabetes?
I use GreenHelix CBD oil, specifically the GreenHelix Recovery and GreenHelix Super Pure products. They help with joint pain relief and ease some of my social anxiety and depression symptoms. The company also has a CBD oil-based sleep product and a skincare cream that I haven’t tried yet, but look interesting.
A New Home Testing Kit Can Screen for Type 1 Diabetes
JDRF has launched a first-of-its-kind program aimed at early detection of type 1 diabetes (T1D), built around an easy to use at-home test kit.
Called T1Detect and developed by Bay Area biotech company Enable Biosciences, this new personal test kit looks for particular autoantibodies in the blood that are the most important markers for T1D.
Given that most T1D diagnoses are dramatic affairs that land many children and adults in the hospital — sometimes with near-death experiences — and a large majority of newly diagnosed have no warning or family history of this chronic condition, a test kit like this could be a gamechanger.
For example, Tom Webb in South Carolina vividly remembers the nightmare of being diagnosed with T1D when he was 7 years old, as his family was moving to a different state.
Without any history of diabetes in the family, the rapid-onset symptoms seemed to come out of nowhere: constantly needing to use the bathroom and extreme thirst, and an overwhelming sense of fatigue. Being so young and en route to a new state, Webb says he had no idea what was happening to his body at the time.
“We moved on a Friday and I went to the doctor on Monday. I don’t know what my blood sugar was, but I was in DKA (diabetes ketoacidosis),” he recalls. “I’m lucky I didn’t end up in a coma or anything.”
Had early T1D screening been available, Webb says his family might have had some idea of the warning signs before he ended up in the emergency room.
For Webb and so many others who’ve been suddenly thrown into the deep end of life with diabetes, this new program offers hope.
“T1Detect is the first and only screening program that will enable a broad population to know their risk of T1D,” says JDRF CEO Dr. Aaron Kowalski, who lives with the illness himself. “This groundbreaking initiative is an important milestone for JDRF because it will increase awareness about early-stage T1D, provide access to crucial education and support for those at risk, and pave the way to ensuring that T1D screening becomes part of universal, clinical preventive services.”
T1Detect is a blood test done by finger prick, similar to traditional fingerstick blood sugar checks. It uses an autoantibody detection panel (ADAP), one of the best ways to detect the most important T1D markers.
The way it works is that you register your information online and order the home kit from manufacturer Enable Biosciences for a price of $55. JDRF is also subsidizing it for those who might not be able to afford the full cost, at a discount price of just $10.
Enable ships the at-home testing kit within a few days.
When it arrives, use the included lancet to do a finger poke and add the blood sample to several little circles on the enclosed card before sending it back to the company by mail to process the results.
Enable will confirm receipt by email and begin processing the sample. Full results can take 4 to 6 weeks, along with a full explanation of what those results mean and your next steps.
JDRF states on its site that “JDRF-funded scientists have discovered that having two or more specific autoantibodies — antibodies that are directed toward your own body or, in the case of T1D, your pancreas — means that you have an almost 100-percent chance of developing T1D.”
Since Enable Biosciences is conducting the screening and collecting the data, it will hold the data for all participants and is governed by existing laws like HIPAA (Health Insurance Portability and Accountability Act). By clicking (or unclicking) a box on the registration site, you can opt-in or out to allow your results to also be shared with JDRF for future research.
“In the future, we may make de-identified data available to members of the T1D research community for certain purposes,” JDRF explains to DiabetesMine.
JDRF is also working with other companies and groups to promote and implement this new screening program:
- MedIQ, a healthcare consulting and education service based in Baltimore, MD, will provide clinician education.
- Nuvera Life Science Consulting in New Jersey will advise on program design and operations.
- California-based non-profit org Beyond Type 1 (BT1), through its JDRF alliance, will provide community support, education, and awareness to patients through the online community.
- Individual donors and corporate sponsors of JDRF are also supporting this, including founding sponsor Provention Bio, a New Jersey-based biopharmaceutical company focused on intercepting and preventing autoimmune diseases.
How does this relate to TrialNet?
Many may be familiar with TrialNet, the global T1D screening research collaboration JDRF has supported since the early 2000s. That program is aimed at families in which one or more members have been diagnosed with T1D and explores the possible hereditary connections.
This new initiative, on the other hand, widens the reach of early screening to those who have no family history of T1D.
“The biggest difference between the programs is that the JDRF T1Detect program does not have any eligibility requirements or age restrictions,” a JDRF spokesperson tells DiabetesMine.
TrialNet’s eligibility requirements limit participation to those with a relative with T1D: ages 2.5 to 45 for those with a parent, child, or sibling already diagnosed, and ages 2.5 to 20 for an expanded list of family members including grandparents, aunts/uncles, and more.
“We need to address that gap,” JDRF says. “There is a great need to increase screening for T1D risk and this program provides a different model for doing that, in a community setting, that adds to and complements existing screening programs, like TrialNet.”
If someone tests positive for T1D using T1Detect, they will be immediately directed to follow up with TrialNet and similar programs to explore clinical trials and other support efforts.
DiabetesMine asked both JDRF and BT1 about awareness and education aimed at family doctors, primary care physicians, community centers, and lower-income hotspots where this early screening could make the most difference for the general population.
Sarah Noel, JDRF’s vice president of community engagement and strategic alliances, says they’ll launch education for healthcare professionals starting in February 2021. It’s part of a long-term strategy to promote T1D risk-screening as part of primary clinical preventive care, she says.
She says educational materials will include email briefs, a live webinar, and online learning modules on a variety of topics, including:
- the importance of talking to families and parents about T1D screening and risk for children
- stages of T1D and preventing DKA
- investigational therapies to slow T1D progression becoming available in clinical settings
- the risks associated with misdiagnosis
“This education will be promoted and available to primary care providers, endocrinologists, pediatricians, pediatric endocrinologists, nurse practitioners, physicians’ assistants, diabetes care and education specialists, nurses and pharmacists, and those caring for underserved communities,” Noel tells DiabetesMine.
Beyond Type 1 adds that it is “working on a wide variety of things to support T1Detect, both digital and physical, and targeted to a wide variety of audiences.”
The benefits of early screening for T1D are undisputed and becoming more clear, especially given the fact that 85 percentTrusted Source of T1Ds have no family history and a diagnosis can arrive suddenly, with potentially life-threatening symptoms already present.
A 2015 clinical study from the TrialNet network confirms that 75 percent of people who have two or more diabetes-related autoantibodies and abnormal blood sugar levels will go on to become insulin-dependent within 5 years.
With those stats in mind and the fact that 40 percent of the newly diagnosed T1Ds present DKA symptoms at the time of diagnosis, it’s no wonder that early screening is an appealing thought. A variety of studies around the world are already proving that pre-screening for T1D can save lives.
Early 2020 clinical researchTrusted Source was the first to explore and publish findings on T1D screening in preschool-aged children, showing that primary care physicians in Germany who screened broadly within the general population had a significant impact on diabetes awareness. Roughly 25 percent of the 280 children screened went on to develop T1D.
“Screening will decrease but not prevent DKA completely,” says Dr. Anette-Gabriele Ziegler, lead study author and director of the Institute of Diabetes Research at Helmholtz Zentrum München in Germany. “Apart from the cases that are missed because they are too young or they have a very rapid progression to clinical disease, there are also some families who will not change how they behave when their child is given a pre-diagnosis.”
And what can be done to halt T1D if early screening shows it’s developing?
A TrialNet study published in the New England Journal of Medicine in 2019 showed that one therapeutic approach is possible using an investigational drug called Teplizumab.
A second trial involving the drug anti-thymocyte globulin (ATG), which is typically used for preventing kidney transplant rejection, also showed similar positive effects in slowing down or stopping disease progression.
Above all, this new T1Detect option presents hope.
In Massachusetts, Sara Weiss recalls how undiagnosed diabetes led to DKA symptoms and the death of her 9-year-old son, Jordan. That was in January 2003, after Weiss had tried to convince local medical professionals to see her son for the extreme thirst, bed-wetting, weight loss, and lethargy that they’d been noticing. An urgent nurse brushed off those warnings signs and his vomiting as the flu and told Weiss to monitor his symptoms rather than see the child.
Jordan died the next morning in his sleep.
“You have to know what to look for in advance of those more severe symptoms and DKA because those alarm bells can’t go off when someone has flu symptoms,” she says. “Maybe an early screening test can raise awareness if those warning signs appear.”
Indiana D-Mom Hope Burton remembers the horror of when her teenage son was hospitalized in DKA during a school band trip to Disney World in his senior year in 2014. The family flew to Florida, terrified after hearing the news, and they drove back after two days of being inundated with new diabetes information. With only a 5-minute lesson at the hospital, Burton says they were unprepared for that new normal.
“It was a nightmare,” she tells DiabetesMine. “There is no one blood-related on either side of our family who has it, so screening wasn’t in our minds and the diagnosis came out of leftfield. I’m not sure what an early screening might have done, but it does offer a sense of hope for those without any family connection. Maybe it would’ve changed this scary, unexpected T1D introduction for us.”
The same goes for Lizzie McKenzie in Missouri, who was diagnosed unexpectedly at age 28 when she went to the doctor for bronchitis. She had been feeling poorly for a couple of months with classic symptoms: peeing frequently, losing weight, and sleeping constantly.
But it wasn’t until blood work following her in-person visit that the truth became known: “emergency level diabetes,” just short of DKA.
At diagnosis, she learned that her A1C level was dangerously high at 11 percent. No one else in her family lives with the condition.
She was extremely lucky not to have experienced DKA or fallen unconscious.
“Catching it early (by chance) saved my life, but I think it’s a great idea to have early screening. It would have helped a lot for me,” she says.
How to Stay ‘Body Positive’ with Diabetes
The long-term impacts of negative body image can be devastating. And what worries experts is that it only takes one comment to send someone down a dangerous road. If diabetes is involved, the effects can be compounded.
“It’s the well-meaning doctor who says something like ‘you better clean up your act or you’re going to have type 2 diabetes,’” Nicole Patience, a nutrition and diabetes educator, and eating disorders specialist at Joslin Diabetes Center in Boston, tells DiabetesMine.
Dr. Samar Hafida, staff physician at Joslin, agrees. She is the assistant medical director of global education and care and a weight management and clinical nutrition specialist.
“It’s not uncommon; in fact, a majority of people have had this experience,” she tells DiabetesMine. “A person comes in (to their medical provider) with a non-weight-connected complaint, and the suggestion is ‘lose weight and you’ll feel better.’
“The result of those kinds of experiences compounded by the world’s focus on thin as beautiful can be the proving ground for depression, self-loathing, and severe eating disorders. That’s an impact that can hit anyone in society,” she says.
For people with diabetes (PWDs), this can be devastating — as they are also faced with blame over their disease by an uneducated general public, comments from the medical field on how weight reduction or diet change is the center of everything, and the challenge of living with a body one feels is failing them.
Could a new focus on “body positivity” be the solution?
Experts feel this movement can and will help PWDs not only feel better about themselves psychologically but be healthier overall.
While it may feel like a new buzz phrase to some, the “body positivity movement” has been around since the late 1960s when women first started pushing back on the notion that all women should be thin.
It took off in recent years for a number of reasons. First, in the late ’90s, a psychotherapist named Connie Sobczak struggling with an eating disorder morphed her background and personal experience to create www.thebodypositive.org, a site dedicated to helping people with self-acceptance.
Then, around 2012, the Body Positive movement took root with bloggers, celebrities, medical experts, and researchers all pushing for the public to not just accept but embrace the concept of all bodies being beautiful.
In recent years, celebrities like singer Lizzo have been vocal and visible in the movement, bringing even more attention to it. The recent October 2020 Fenti fashion show from singer Rihanna featured models of all sizes, colors, and looks in a nod to body positivity.
Joslin’s Patience says that it’s all about “taking care of the body you live in. It’s about respecting it and recognizing how it serves you in very positive ways.”
What body positivity is not, she says, is a call to ignore healthy suggestions and interventions that you may need.
“Some see it as a double-edged sword,” explains Hafida. “Some worry that embracing oneself as you are will block people from accepting (medical help). But it’s not an either/or concept. Being body positive should not mean you’re not receptive to taking advice and taking action.”
What it does mean is this: Loving the body you are in as it is in this moment leads to better health outcomes overall.
It’s a difficult thing to embrace for the overweight, Hafida says.
“Society tells us we need to look a certain way, be a certain way. That’s hard to overcome.”
For the PWD of any kind, the challenge of finding body positivity is exacerbated by the need to wear medical devices, the struggle with weight control some face, things like scarring on the body, and just the feeling, overall, that your body has failed you.
And there is of course the stigma and “blame” that the general public associates with any type of diabetes.
“Even with type 1 (and often with type 2), others say, ‘Oh, you must have caused your diabetes,’” says Patience.
She points out that her first step with a patient is reminding them that with type 1 or type 2 diabetes: This is not your fault.
“There is no reason to blame yourself,” she says. “Body size is not a direct indication of whether you take care of yourself or not.”
There are other specific other body image challenges that come with diabetes, she adds, pointing to these as just a few:
- Visible devices that draw attention to the person or the body
- How clothes fall on the body around those devices
- Scarring, such as lipohyperatrophy from years of shots and insulin pump sites, which, Patience says, while not always visible to the world, is visible to the person who has them
All this can lead to dangerous reactions in PWDs.
Marcia Meier, program manager at the Patient Services International Diabetes Center in St. Louis Park, Minnesota, has treated over 500 diabetes patients with eating disorders and other body-related struggles since 2005.
The ugly truth, she tells DiabetesMine, is that the impact of negative body image on PWDs, particularly women, can be profound.
“About 36 to 40 percent of women with type 1 diabetes manipulate insulin to control their weight,” she says.
“There is this concept of insulin use equals fat, and right there, you’ve got a predisposition to some of those problems.”
Meier traces the issue back to the general public, of course, but also to a place that may surprise many: the endocrinology office.
“Just about every article you read, all that you can pick up right in your endocrinology office, clearly says that insulin causes weight gain,” she says.
“Most women want to be a body size that is smaller than they are, diabetes or not,” she says.
The dangerous difference between the PWD? Access to a relatively simple yet life-risking way to drop the weight.
“Most people do not have the kind of touch on the body that people with diabetes do,” she says. “All a person with diabetes had to do to lose weight is not do something. They don’t have to exercise or starve. They just have to omit their insulin.”
Of the patients she’s treated, she says negative body image “has been a part of (the struggle) of every single one of them.”
It’s not always insulin omission, though. She’s had a diabetes patient who purposely let her glucose levels run low because “she only gave herself permission to eat when low.”
This drive to be thin does not necessarily stem from being raised in a household judging you. In fact, Meier says, even the person raised with all the right cues can fall prey to public comment.
“That’s a huge challenge I see. You can be raised (with body positivity) in your household and literally delve into an eating disorder from one thing a person says.”
It could be as simple as your aunt saying you should skip the dessert so you don’t get fatter and “worse with your diabetes.” Or a magazine spread with the “plus-sized models” who are actually a size 8 or 10. Or the doctor who tells you your weight is the cause of all troubles. One negative comment is all it takes, she says, to set a person down a dangerous road.
Like so many other things, this takes a village. PWDs need the world, media and yes, their own doctors, to understand and embrace this, experts say. They also need themselves.
Some ways to build body positivity include:
It starts with you. Patience says when a person meets with her for the first time, she’s quick to strike down any self-negativity.
“People come in and make derogatory remarks about themselves because it’s been normalized so much,” she says. “I tell them right away: it’s not acceptable here.”
She helps those struggling learn, understand, and, most of all, embrace seeing that their body does many good things for them every day and that loving it for that helps overall health.
Meier agrees, adding that while society needs change here, “I cannot change the world. What I can do is help them deal with those comments.”
“They need to develop a belief system so that when things are said to them (even by doctors), they can recognize that — even if coming as well-intentioned — those comments may not be healthy for them, or even be the truth. It’s about not believing everything you hear and read.”
PWDs also need to recognize the good that both their body and insulin does, Meier says, as well as the good technology they may wear does.
For example, beauty queen Sierra Sandison was a teenager when diagnosed with type 1 diabetes, and due to body image notions, she pushed off getting a pump and CGM for a period of time.
“I was a senior in high school and already having a hard time with body image when I was diagnosed,” she tells DiabetesMine.
“I was angry at my body before that, and once I was diagnosed, I was angry at it for what I saw as failing me on the inside too.”
She decided to hide her diabetes until she heard about Miss America 1999 Nicole Johnson, who has type 1 and proudly displays it.
That led Sandison to make it into the 15 finalists for Miss America as Miss Idaho 2014, where she walked the stage in the bathing suit competition proudly showing her pump. Thousands followed her lead, making the hashtag #ShowMeYourPump go viral, and more importantly helping others heal as she did herself.
“Now I’m like: if someone does not want to date me because I have a pump, good riddance,” she says.
Finding medical support that “gets it.” Patience is one of more than 17,000 medical providers who have signed on as part of the “Healthy At Every Size” movement that provides resources and encourages healthcare professionals to take a pledge to be aware, respectful, and compassionate of all issues surrounding body size.
More and more providers are adopting this, and Patience suggests you seek them out, or ask your medical provider to check it out.
Hafita said it can be life-changing when you seek out a medical expert who understands that if you are a bit overweight, it makes no sense to focus on fault.
“Weight gain is a chronic disease,” she says. “No matter how many ‘mistakes’ you think you have made, it’s not your fault.”
She asks people to consider this: Some of our friends can gobble down all the goodies, barely work out and be thin. Others walk daily, count carbs and still struggle with weight.
“Seeing someone who can understand is key,” she says.
Avoid rash diets, particularly for children. Keto eating, for example, can be too extreme, Hafita said.
“That is absolutely not normal eating,” she explains, in large part because it is so difficult to maintain. “There are people who think you can eat that way for the rest of their life, but the reality is, much of our social structure centers around food. We celebrate with it; we gather around it. It’s not the best idea to raise a child to think they are failing if they enjoy those moments.”
Know when to take action. If you struggle with body image issues and have ever omitted insulin or starved yourself, you may want to seek a therapist to help you build a better image of yourself.
That can range from a therapist you connect with to a trained expert in diabetes and body image.
In the end, learning to embrace our bodies as they are, big or small; dark or light; tall or short; whatever you are, is key to overall health, all agree.
“It’s important to understand, as I now do, that healthy looks different on everyone,” says Sandison.
“We have to get past this ‘skinny is healthy’ concept and we should strive for all to do that,” she concludes.