Consideration of cannabinoids in the treatment of Diabetic Peripheral Neuropathic Pain


  • Taylor Lougheed, MD Section of Emergency Medicine, Northern Ontario School of Medicine; Department of Family Medicine, University of Ottawa



Diabetic Peripheral Neuropathic Pain (DPNP) is a leading complication of diabetes that can have marked impacts on quality of life, may lead to increased depressive symptoms, and can be difficult to treat due to medication side effects.  As a result, there has been growing interest in exploring adjunctive treatment options for chronic neuropathic pain, including medical cannabinoids. While the pathogenesis of DPNP is not fully understood, there is evidence that persistent hyperglycemia contributes to a number of processes leading to vascular damage, increased oxidative stress, and release of free radicals and pro-inflammatory molecules4,5—all of which may lead to DPNP symptoms, including pain.

Author Biography

Taylor Lougheed, MD, Section of Emergency Medicine, Northern Ontario School of Medicine; Department of Family Medicine, University of Ottawa

Dr. Taylor Lougheed is a family, emergency, sport, and cannabinoid physician living and practicing in North Bay, Ontario. He completed his medical school training at Queen’s University, his family medicine residency at the University of Toronto, and his emergency medicine enhanced skills residency at the University of Ottawa. He is an experienced cannabinoid physician with a consult-based practice that focuses on complex refractory conditions in all ages and has given over 100 cannabinoid based academic talks. Dr. Lougheed is an Assistant Professor at the Northern Ontario School of Medicine and the University of Ottawa.


Van Acker K, Bouhassira D, De Bacquer D, Weiss S, Matthys K, Raemen H et al. Prevalence and impact on quality of life of peripheral neuropathy with or without neuropathic pain in type 1 and type 2 diabetic patients attending hospital outpatients clinics. Diabetes Metab J. 2009 Jun 1;35(3):206-213. doi:10.1016/j.diabet.2008.11.004 DOI:

Alghafri RM, Gatt A, Formosa C. Depression symptoms in patients with diabetic peripheral neuropathy. Rev Diabet Stud. 2020 Jul 30;16(1):35-40. DOI:

Rosenberg CJ, Watson JC. Treatment of painful diabetic peripheral neuropathy. Prosthet Orthot Int. 2015 Feb;39(1):17-28. doi:10.1177/0309364614542266 DOI:

Rosenberger DC, Blechschmidt V, Timmerman H, Wolff A, Treede RD. Challenges of neuropathic pain: focus on diabetic neuropathy. J Neural Transm. 2020 Apr;127(4):589-624. doi:10.1007/s00702-020-02145-7 DOI:

Etienne I, Magalhães LV, Cardoso SA, de Freitas RB, de Oliveira GP, Palotás A, et al. Oxidative stress markers in cognitively intact patients with diabetic neuropathy. Brain Res Bull. 2019 Aug 1;150:196-200. DOI:

Zou S, Kumar U. Cannabinoid receptors and the endocannabinoid system: signaling and function in the central nervous system. Int J Mol Sci. 2018 Mar 13;19(3):833. DOI:

Atalay S, Jarocka-Karpowicz I, Skrzydlewska E. Antioxidative and anti-inflammatory properties of cannabidiol. Antioxidants. 2019 Dec 25;9(1):21. doi:10.3390/antiox9010021 DOI:

Iffland K, Grotenhermen F. An update on safety and side effects of cannabidiol: a review of clinical data and relevant animal studies. Cannabis and cannabinoid research. 2017 Jun 1;2(1):139-154. DOI:

Moulin DE, Boulanger A, Clark AJ, Clarke H, Dao T, Finley GA, et al. Pharmacological management of chronic neuropathic pain: revised consensus statement from the Canadian Pain Society. Pain Research and Management. 2014 Nov 1;19(6):328-335. DOI:

Häuser W, Finn DP, Kalso E, Krcevski-Skvarc N, Kress HG, Morlion B, et al. European Pain Federation (EFIC) position paper on appropriate use of cannabis-based medicines and medical cannabis for chronic pain management. Eur J Pain. 2018 Oct;22(9):1547-1564. DOI:

Petzke F, Karst M, Gastmeier K, Radbruch L, Steffen E, Häuser W. Ein Positionspapier zu medizinischem Cannabis und cannabisbasierten Medikamenten in der Schmerzmedizin. Der Schmerz. 2019 Oct;33(5):449-465. DOI:

Moisset X, Bouhassira D, Avez Couturier J, Alchaar H, Conradi S, Delmotte MH, et al. Pharmacological and non-pharmacological treatments for neuropathic pain: systematic review and French recommendations. Rev Neurol (Paris). 2020;176:325–352. doi:10.1016/j.neurol.2020.01.361 DOI:

Price R, Smith D, Franklin G, Gronseth G, Pignone M, David WS, et al. J. Oral and topical treatment of painful diabetic polyneuropathy: practice guideline update summary: Report of the AAN Guideline Subcommittee. Neurology. 2022 Jan 4;98(1):31-43. doi:10.1212/wnl.0000000000013038 DOI:

Weizman L, Dayan L, Brill S, et al. Cannabis analgesia in chronic neuropathic pain is associated with altered brain connectivity. Neurology. 2018;91(14):e1285-e1294. DOI:

Xu DH, Cullen BD, Tang M, Fang Y. The Effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities. Curr Pharm Biotechnol. 2020;21(5):390-402. DOI:

Ueberall MA, Essner U, Mueller-Schwefe GH. Effectiveness and tolerability of THC: CBD oromucosal spray as add-on measure in patients with severe chronic pain: analysis of 12-week open-label real-world data provided by the German Pain e-Registry. J Pain Res. 2019;12:1577. DOI:

Ueberall MA, Essner U, Silván CV, Mueller-Schwefe GH. Comparison of the effectiveness and tolerability of nabiximols (THC: CBD) oromucosal spray versus oral dronabinol (THC) as add-on treatment for severe neuropathic pain in real-world clinical practice: retrospective analysis of the German pain e-registry. J Pain Res. 2022;15:267. DOI:

Bhaskar A, Bell A, Boivin M, Briques W, Brown M, Clarke H, et al. Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. J Cannabis Res. 2021 Dec;3(1):1-2. doi:0.1186/s42238-021-00073-1 DOI:



How to Cite

Lougheed, T. (2023). Consideration of cannabinoids in the treatment of Diabetic Peripheral Neuropathic Pain. Canadian Diabetes & Endocrinology Today, 1(1), 11–15.