Canabidiol para controle glicêmico em Diabetes Mellitus: uma revisão sistemática e meta-análise

Abstract

The loss of pancreatic beta cell function, associated with insulin resistance, contributes to the persistent hyperglycemia characteristic of Diabetes Mellitus (DM). This glycemic dysregulation promotes alterations in biochemical markers, such as HbA1c, fasting and postprandial blood glucose, and insulin levels. Although pharmacotherapy is essential for the management of DM, its adverse effects, mainly gastrointestinal and hypoglycemic, can compromise adherence to treatment. In this scenario, cannabidiol (CBD), a phytocannabinoid derived from Cannabis sativa, has demonstrated great therapeutic potential for various conditions, including epilepsy, chronic pain, and DM. Therefore, this systematic review sought to analyze evidence on the use of CBD in the control of hyperglycemia. The search in four databases identified 856 articles, of which 15 studies were selected, 14 preclinical and 1 clinical. Nine preclinical studies demonstrated a reduction in glucose levels, possibly associated with modulation of the endocannabinoid system, especially in the inhibition of anandamide degradation and consequent stimulation of canonical and non-canonical receptors that are also part of metabolic control. A meta-analysis of 14 in vivo studies indicated that CBD significantly decreased blood glucose levels. The studies presented a risk of bias ranging from low to moderate. It is concluded that CBD shows potential for controlling hyperglycemia, although further preclinical and clinical studies are needed to elucidate the mechanisms involved in regulating blood glucose levels and thus guide new therapeutic approaches and research on the subject, serving as supporting material for possible clinical applications.