The Benefits of Medical Marijuana in Diabetes

Diabetes affects millions of Americans, and while many people think of it mainly as a blood sugar problem, the reality is much more complex. Over time, elevated blood glucose damages blood vessels, nerves, organs, and immune function. One of the most painful complications — diabetic neuropathy — can be debilitating. Burning, stabbing, or electric pain in the feet and hands can rob patients of sleep, mobility, and quality of life. Traditional medications such as gabapentin, duloxetine, pregabalin, and strong opioids are often prescribed, but many patients experience limited relief or intolerable side effects.

More people are turning to medical cannabis as a gentler, more effective option, and modern research is catching up to what many patients have been saying for years: cannabis helps. A recent comprehensive review, “Longitudinal Study: Inhaled Cannabis Is ‘Safe and Effective’ for Treating Refractory Diabetic Neuropathy,” published in Biomedicines and summarized by NORML in October 2025, provides some of the strongest long-term clinical evidence to date. The findings highlight not only meaningful pain relief, but also improvements in blood sugar control — a remarkable advantage unique to cannabis therapy.

Below, I’ll break down what the research means, how cannabis interacts with diabetic physiology, and why it matters for patients looking for safer, more effective treatment options.

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Understanding Diabetic Neuropathy

Diabetic neuropathy is caused by chronic nerve damage caused by high blood sugar levels, most often in the lower extremities. Patients describe burning, numbness, tingling, sharp electrical shocks, and painful sensitivity to touch. At night, when stimulation is minimal, neuropathy pain can feel severe enough to wake patients from sleep.

Traditional medications help some, but many people continue to struggle despite high-dose regimens. Some of these drugs also cause sedation, cognitive fog, gastrointestinal upset, dizziness, imbalance, or tolerance. Long-term opioid use carries even more concerns — dependence, constipation, respiratory suppression, and overdose risk.

So when a treatment comes along that reduces pain and reduces dependence on stronger medications, physicians pay attention.

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What the New Research Shows

The new longitudinal study from Israel followed 50 patients with treatment-resistant diabetic neuropathy who inhaled standardized medical cannabis (20% THC and 1% CBD) for five years. These were not occasional users — they used cannabis as a routine part of their care. The findings were remarkable:

✅ Pain Scores Dropped Sharply

• Patients started with an average pain rating of 9 out of 10

• After long-term cannabis therapy, this fell to 2 out of 10
  That level of improvement is rarely seen in chronic neuropathy.

✅ Patients Were Able to Dramatically Reduce Other Medications

Over five years, participants reduced:

• Opioids by >90%

• Gabapentin by 97%

• Duloxetine by 93%

• Pregabalin by 79%

Even more impressive — they did not develop rebound pain after tapering off the other drugs. That means cannabis didn’t just mask symptoms; it helped control them.

✅ Better Blood Sugar Control

Average A1c decreased from 9.77% to 7.79% — a major improvement for a diabetic patient. This is consistent with earlier studies showing cannabinoids may help regulate glucose metabolism and reduce insulin resistance.

✅ No Serious Adverse Events

Not a single severe side effect was reported over five years.

The authors concluded that inhaled cannabis is both safe and effective for patients with refractory diabetic neuropathy — not only for pain relief, but for metabolic benefits and a reduced need for other medications.

NORML Deputy Director Paul Armentano summarized it well:

“Cannabis effectively mitigates hard-to-treat neuropathic pain while also providing metabolic benefits, particularly for those with or at risk of adult-onset diabetes.”

Even broader research supports this. A meta-analysis including 478,000 participants found cannabis users were 52% less likely to develop type 2 diabetes than non-users — suggesting cannabinoids may have protective metabolic effects.

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How Cannabis Helps Neuropathy Pain

Cannabis works differently from conventional medications. With neuropathy, nerves fire excessively, and pain signals continue even when nothing is happening in the body. The endocannabinoid system (ECS) — a signaling system all humans have — helps control inflammation, pain signals, and immune function. Cannabinoids such as THC and CBD bind to receptors throughout the nervous system:

● THC reduces nerve firing and pain signaling

THC activates CB1 receptors in the brain and spinal cord, quieting overactive nerve impulses that cause burning and electric shock sensations. It also improves sleep, which is especially meaningful for nighttime neuropathy.

● CBD reduces inflammation and oxidative stress

Inflammation aggravates neuropathy. CBD has anti-inflammatory and antioxidant effects, helping protect nerves from further damage.

● Combined THC + CBD provides the best benefit

Many studies — including the recent longitudinal data — show the greatest pain relief when both cannabinoids are used together. This “entourage effect” means cannabinoids work better as a team than in isolation.

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Metabolic Benefits: Why Blood Sugar Improves

Although many people assume cannabis affects only pain or mood, the ECS also plays a key role in metabolism. Cannabinoid receptors are present in the pancreas, liver, GI tract, and fat cells — the very organs linked to diabetes.

Research suggests several possible ways cannabis improves glucose control:

✅ Reduced inflammation

Chronic inflammation contributes to insulin resistance. CBD appears to lower inflammatory markers that interfere with normal glucose metabolism.

✅ Better sleep

Poor sleep increases cortisol and blood sugar. Cannabis often helps patients fall asleep and stay asleep, which supports a healthier metabolic balance.

✅ Lower pain and stress

Physical pain triggers the release of stress hormones, which worsen glucose control. When pain decreases, so does the metabolic burden.

✅ Improved nerve and vascular function

Better circulation and reduced nerve stress may help slow the progression of neuropathy itself.

While this does not mean cannabis replaces diabetes medications, the improvements in A1c seen in long-term users cannot be ignored. For many, cannabis works as a helpful adjunct to standard care — not a standalone cure.

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Safer Than Many Traditional Options

One reason I recommend cannabis therapy for selected patients is that its safety profile is reassuring compared to traditional neuropathy medications.

Opioids carry the risk of respiratory depression, dependence, constipation, and overdose.
Gabapentin and pregabalin can cause sedation, dizziness, imbalance, and swelling.
Duloxetine often brings nausea, insomnia, dry mouth, and blood pressure changes.

Cannabis, when used properly, typically causes only mild, manageable effects:

• Dry mouth

• Temporary dizziness

• Increased appetite

• Short-term memory changes at higher doses

There is no lethal overdose level for cannabis, and long-term use in the study caused no serious adverse events. Patients also reported that cannabis made them feel more functional, not less — a meaningful difference for those trying to stay active.

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Different Ways Patients Can Use Cannabis

For diabetic neuropathy, patients often find benefit in using:

✅ Inhaled flower or vaporized oil – fast relief for breakthrough pain
✅ Edibles – longer-lasting support overnight
✅ Tinctures – easy to dose and combine with sleep routines
✅ Topicals or balms – local relief on feet and legs
✅ Balanced THC/CBD strains – strong pain control with gentle psychoactive effects

Each method has pros and cons, and dosing should be individualized. Most patients do best by starting low and gradually increasing until pain relief is stable.

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Is Medical Cannabis Right for Every Diabetic Patient?

Like any therapy, cannabis is not ideal for everyone. It should be avoided or used cautiously in:

• Patients with unstable heart disease

• Those with a history of psychosis

• Pregnancy or breastfeeding

• Patients with poorly controlled nausea or unpredictable intake (edibles may be delayed)

However, for many adults with neuropathy, insomnia, chronic pain, or opioid dependence, cannabis can offer meaningful relief without the heavy baggage of traditional medicines.

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The Bottom Line

For decades, diabetic neuropathy has been one of the most difficult chronic pain conditions to treat. Many patients feel trapped: strong medications bring strong side effects, and pain persists anyway.

Now, evidence shows a clearer path forward.

Medical cannabis is:
✔ Safe
✔ Effective
✔ Long-lasting
✔ Helpful for blood sugar
✔ Opioid-sparing
✔ Well-tolerated over years of use

The five-year study highlighted by NORML shows sustainability: reduced pain, improved function, tapering of other medications, and better metabolic outcomes. Few treatments can claim those combined benefits.

For patients with diabetes who feel out of options, medical cannabis may provide relief and restore quality of life in ways that traditional therapy has not.

If you or someone you love is struggling with diabetic neuropathy, a medical cannabis evaluation can determine whether this therapy might be appropriate. With careful dosing, follow-up, and physician guidance, cannabis can become a powerful tool in managing both pain and overall diabetic health.

If you’d like help getting certified or learning which products may work best for you, ReThink-Rx can guide you every step of the way.

Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions about your health or medical conditions.