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Diabetes and the Use of Complementary and Alternative Medicine

Aug 25, 2018
 

Alternative medicine and diabetes: herbal therapies and acupuncture among the most common alternative therapies used by patients with diabetes.

Glucose-lowering medications have long been the mainstay for treatment of both type 1 and type 2 diabetes, but little is known about the effects of complementary and alternative medicine (CAM) in patients with diabetes. In 2012, it was estimated that over 2 million adults with diabetes age 65 and older used some form of CAM (complementary and alternative medicine)  for either treatment or general wellness over the course of the year.

In a study published in June 2018, investigators examined data from the 2012 National Health Interview Survey (NHIS), which included CAM-related information from 1,475 adults age 65 and older with any type of diabetes. Patients were assessed for type of CAM used, reason for use (treatment only, wellness only, or both treatment and wellness), and prevalence of use over the course of one year. The mean age of patients was 72.4 years and females made up 54.3% of patients.

Of the 1,475 patients, biologically based and manipulative body therapies were the most commonly used class of CAM. The most common individual CAM therapies were herbal, chiropractic, massage, acupuncture, and yoga. A statistically significant difference of reason for use was observed in herbal therapies, chiropractic therapy, and meditation. Individual results are shown below:

CAM (Class) Prevalence of use (%)
Biologically based therapies 62.8
Manipulative body therapies 36.8
CAM (Individual) Prevalence of use (%)
Herbal therapies 62.8
Chiropractic therapy 23.9
Massage therapy 14.7
Acupuncture 10.2
Yoga 5.2
CAM Reason for use P value
Herbal therapies Wellness only 0.03
Chiropractic therapy Treatment only <0.001
Meditation Both treatment and wellness 0.046

As patients with diabetes continue to seek alternative therapies either in addition to, or in lieu of, standard pharmacotherapy, practitioners need to become more proactive in their knowledge of CAM therapies in order to better serve their patients. This should not only be applicable to older patients with diabetes, however. The 2012 NHIS data also showed that 11.6% of children with any condition used some form of CAM to treat specific conditions. As the use of alternative medicine continues its steady rise in prevalence in the United States, clinicians must begin to inquire about such therapies with patients so that individuals may be better assessed for potential harm as well as improvement in health.

Practice Pearls:

  • Over 2 million adults in the United States with diabetes used some form of complementary and alternative medicine (CAM) for overall wellness and treatment of their diabetes.
  • The most commonly used class of CAM in patients with diabetes are herbal therapies and manipulative body therapies, such as chiropractic and massage therapy.
  • Further studies must be conducted evaluating the efficacy and safety of CAM in patients of all ages who have diabetes.

References – Alternative Medicine and Diabetes:

Rhee, G.T, Westberg, S.M, and Harris, I.M. (2018) Use of Complementary and Alternative Medicine in Older Adults With Diabetes. Diabetes Care. 41(8), PubMed, doi.org/10.2337/dc17-0682

“Children and the Use of Complementary Health Approaches.” National Center for Complementary and Integrative Health, U.S. Department of Health and Human Services, 18 July 2018, nccih.nih.gov/health/children.

Clarke Powell, Pharm.D. Candidate 2019, LECOM School of Pharmacy