As a multisystem disease, diabetes often comes with a range of secondary conditions. One of these complications is diabetic neuropathy. Approximately 50 percent of diabetes patients develop this condition at some point in their lives. It is a nerve damage caused by persistently elevated blood sugar levels and manifests as pain and abnormal sensations.
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Treatment is often challenging because opioids—apart from their high addiction risk—have limited effectiveness for chronic neuropathic pain. Other painkillers also frequently fail to provide adequate relief. A recently published long-term study from Israel has now demonstrated that medical cannabis can produce significant pain reduction with minimal side effects. By adding cannabis to standard therapy, not only were pain levels reduced, but blood sugar values also improved.
Study of 50 Patients
The study recruited 50 patients suffering from treatment-resistant diabetic neuropathy. All participants had undergone at least three unsuccessful treatment attempts with conventional methods. The patients received medical cannabis containing 20% THC and less than 1% CBD, which was inhaled via a vaporizer.
The inhalation route was chosen to ensure rapid onset of action for acute pain episodes. Dosing was individually tailored to each patient’s needs. Participants were monitored over a five-year period to capture the long-term effects of cannabis therapy.
Pain perception and motor impairments were regularly assessed using standardized scales—the BPI (Brief Pain Inventory) and the LANSS-Score (Leeds Assessment of Neuropathic Symptoms and Signs). The BPI rates the type and intensity of neuropathic pain on a 10-point scale, while the LANSS-Score classifies pain and abnormal sensations from 0 to 24 points.
Long-term effects on blood sugar levels were also tracked, measured by HbA1c values. This indicates what percentage of hemoglobin in the blood is bound to sugar, providing insight into average blood sugar levels over the previous 8 to 12 weeks. In healthy individuals, this value is below 5.7%.
Dramatic Pain Reduction and Lower Opioid Use
The results were impressive: At baseline, participants had an average BPI score of 9 points. Cannabis therapy reduced this to 2 points. Perceived impairment also decreased significantly—from an average of 7.5 to 2.2 points. On the LANSS scale, improvements were shown from 19.4 to 10.2 points.
This proved cannabis to be a highly effective adjunctive treatment for relieving pain and significantly improving quality of life. Furthermore, the average HbA1c value dropped from 9.77% to 7.79%, indicating a noticeable improvement in blood sugar control.
Another positive effect: Participants‘ opioid consumption decreased substantially—by up to 62 morphine equivalents. This metric shows what dose of an opioid is needed to achieve the effect of a given amount of morphine.
Minimal Side Effects and Stable Results
The therapy demonstrated a particularly favorable safety profile. Only 15.4% of patients reported mild side effects such as dry mouth. The positive effects remained stable throughout the entire observation period.
For patients, this is a major relief, as opioids are known to cause strong tolerance development, which frequently leads to dose escalation. Participants‘ blood sugar levels remained consistently stable throughout the study duration.
Researchers suspect that the neuroprotective properties of cannabis may additionally help slow the progression of nerve damage. The exact mechanism by which activation of CB1 and CB2 receptors alleviates diabetic neuropathy symptoms is not yet fully understood. Future larger studies with biomarker analyses should help clarify these processes and enable even more individualized therapies.
Sources
- Study:
https://pubmed.ncbi.nlm.nih.gov/41153689/
- HbA1C Explained:
https://www.gesundheitsinformation.de/hba1c-haemoglobin-a1c-wert.html
- BPI Explained:
https://www.schmerzgesellschaft.de/fileadmin/pdf/LONTS_Praxiswerkzeug_03.pdf
- LANSS Explained:
https://www.digotor.info/Downloads/Scores/Schmerz_Psych/Leeds_Assessment_of_Neuropathic__Symptoms_and_Signs_LANSS_09-2023.pdf
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