Diabetic peripheral neuropathy (DPN) is the most common form of neuropathy (numbness and tingling in hands and feet) in the developed world, as well as the most frequent neurological complication of diabetes management. It is a distal symmetric polyneuropathy that can be a model for neuropathic pain, but new studies show that inhaling marijuana can reduce its painful effects.
Symptoms include paresthesias, numbness, and, in some patients, burning and lancinating pain in the lower limbs. DPN is caused by axonopathy and follows a length-dependent pattern, with the longest axons involved first distally. The sensory manifestations often begin in the toes and progress slowly toward the head and to the lower parts of your legs. They generally do reach the fingertips or hands when the lower limb symptoms are at around the level of the knees.
Once established, sensory diabetic neuropathy is persistent even if hyperglycemia is controlled. Treatment options for DPN are limited, with many of the existing options causing excessive sedation and fall risk.
However, when a randomized, double-blinded, placebo controlled crossover study was conducted on painful DPN to assess the efficacy and tolerability of inhaled cannabis, there was a significant difference in spontaneous pain scores (P < .001). This placebo-controlled trial of inhaled cannabis demonstrated a dose-dependent reduction in DPN pain in patients with treatment-refractory pain. This evidence further supports the efficacy of the cannabinoids in neuropathic pain.
Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy
The Journal of Pain. Volume 16, Issue 7, July 2015, Pages 616-627