A 62-year-old Hispanic obese man (weight 113 kg, BMI 39 kg/m2) with a history of type 2 diabetes for 11 years began taking CBD oil to control his blood glucose in place of insulin degludec. Initiation of this product was independent of his clinician’s recommendation and based on the patient’s personal review of information that suggested CBD was beneficial for people with type 2 diabetes.
The week before the patient’s initiation of CBD, his A1C was 7.6%, and he was taking his currently prescribed medications: insulin degludec 32 units subcutaneously daily, metformin 1,000 mg orally twice daily, and empagliflozin 25 mg orally once daily. The patient reported adherence to his medications 6 days out of the week. Insulin degludec had been supplied as a sample, but his refill history suggested exceptional adherence to metformin and empagliflozin. His self-monitoring of blood glucose (SMBG) readings ranged from 124 to 176 mg/dL, with an average of 144 mg/dL. Because he was not meeting his goal A1C of <7.0%, he was prescribed saxagliptin 5 mg to be taken once daily. The patient had no macrovascular complications of diabetes and had normal liver and renal function but did have albuminuria.
One week later, the patient contacted his provider to report that he had self-discontinued insulin degludec after an episode of hypoglycemia and replaced his insulin therapy with 20 mg of oral CBD daily (SA Botanicals, San Antonio, TX). Given his history of side effects to glucagon-like peptide 1 receptor agonists and refusal to use insulin again because of concerns about hypoglycemia, the clinician agreed with his decision to discontinue insulin and suggested evaluating the patient’s A1C on triple oral therapy plus CBD at his next visit.
At the next clinic visit 6 weeks after his CBD initiation, the patient’s SMBG readings ranged from 122 to 158 mg/dL, with an average of 142 mg/dL. Based on his refill history and self-report, he had been adherent to his regimen of metformin, empagliflozin, saxagliptin, and CBD oil, and he reported no changes in diet or lifestyle. His weight remained stable at 112 kg.
Because his SMBG readings had not drastically changed with the discontinuation of insulin degludec, no medication changes were made. After 4 months of using CBD oil, the patient increased his CBD dose to 18 mg twice daily and self-reported benefits for joint pain management. After 13 months of the patient’s same medication regimen, his A1C remained stable at 7.7%, and his weight was 113 kg
Mattes RG, Espinosa ML, Oh SS, Anatrella EM, Urteaga EM. Cannabidiol (CBD) Use in Type 2 Diabetes: A Case Report. Diabetes Spectr. 2021 May;34(2):198-201. doi: 10.2337/ds20-0023. Epub 2021 Dec 23. PMID: 34149261; PMCID: PMC8178711.
Courtesy of the National Library of Medicine