Complementary and Alternative Medicine Therapies for Diabetes: A Clinical Review

Abstract

C omplementary and alternative medicine (CAM) refers to a wide range of clinical therapies outside of conventional medicine.1 The term “complementary” refers to therapies that are used in conjunction with conventional medicine, whereas “alternative” medicine includes therapies that are used in place of conventional medicine. The term “integrative” medicine has been advocated by some CAM providers and researchers as representing a combination of conventional medicine, CAM, and evidence-based medicine.2 The National Center for Complementary and Alternative Medicine, a federal scientific agency for CAM research, categorizes CAM into five domains: biologically based practices, mind-body medicine, manipulation and body-based practices, energy medicine, and whole-medical systems (Table 1). Biologically based practices and mind-body medicine are the most common CAM modalities used and studied for the treatment of diabetes in the West and are the focus of this review. In the United States, CAM is frequently used by adults, with 40% reporting use in the past 12 months.3 An estimated 34% of adults with diabetes use some type of CAM therapy.4 The estimated out-of-pocket expense in 2007 on CAM therapies was $44 billion.5 Although some CAM therapies have been shown to affect glycemic control, the clinical efficacy and mechanism of many CAM therapies for diabetes is controversial, and safety issues are a concern. Adverse effects of many CAM therapies are not well documented. Because patients with diabetes often take multiple prescription medications, there exists the potential for herb-drug and herb-dietary supplement interactions, leading to adverse events.6,7 At least 63% of the general population do not disclose use of CAM therapies to their physicians.8 The purpose of this clinical review is to discuss selected CAM therapies frequently used for patients with diabetes and to provide a framework to advise patients on CAM use. INBRIEF More than …