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People who have diabetes are twice as likely to use complementary and alternative medicine as other patients

People with diabetes are much more likely than other patients to use complementary and alternative medicine (CAM). However, they seem to use CAM not as a substitute for conventional treatment but as an adjunct to conventional treatment, finds a study supported in part by the Agency for Healthcare Research and Quality (HS11418 and HS10871). In this study, 57 percent of people with diabetes who used CAM discussed it with their regular physician, and 43 percent were actually referred to other CAM users by a physician.

Leonard E. Egede, M.D., M.S., and his Medical University of South Carolina colleagues suggest that doctors acknowledge use of CAM and discuss it candidly with their patients. The researchers compared the prevalence and pattern of CAM use in people with and without diabetes using data from AHRQ's 1996 Medical Expenditure Panel Survey, a nationally representative sample of the U.S. household civilian population. After controlling for age, sex, race/ethnicity, household income, educational level, and coexisting medical conditions, people with diabetes were 1.6 times as likely to use CAM as people without diabetes (8 vs. 5 percent). Individuals who had only diabetes were twice as likely to use CAM, whereas those with diabetes and additional chronic conditions were 1.8 times as likely to use CAM as the general population without chronic medical conditions.

The most frequently used CAM treatments by people with diabetes were nutritional advice and diets, spiritual healing (21 percent), herbal remedies (20 percent), massage, and meditation. Many of the CAM nutritional/dietary recommendations (for example, homeopathic diets and orthomolecular therapies such as magnesium, melatonin, or megadoses of vitamins) differ from conventional dietary recommendations endorsed by diabetes educators and physicians. Recent studies have shown that prayer and spiritual healing by a clergyman or spiritualist improve treatment effects. In contrast, use of herbal remedies has not been shown to improve glucose control and may even be harmful in people who have diabetes.

See "The prevalence and pattern of complementary and alternative medicine use in individuals with diabetes," by Dr. Egede, Xiaobous Ye, M.D., M.S., Deyi Zheng, M.B., Ph.D., and Marc D. Silverstein, M.D., in the February 2002 Diabetes Care 25(2), pp. 324-329.

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