Complementary and alternative system of medicine for type 2 diabetes mellitus and its complications: A scoping review

Abstract

Background This review aims to map the evidence on the effectiveness of Complementary and Alternative Medicine (CAM) for Type 2 Diabetes Mellitus (T2DM) and its associated complications and identify research gaps in key outcomes and CAMs. Methods Our scoping review was informed by Johanna Briggs Institute guidelines. We searched electronic databases from inception to March 2020 and references of included studies. The experimental and non-randomized studies with intervention and control arm were mapped based on the effectiveness of various CAM (Yoga, Ayurveda, Homeopathy, Siddha, Naturopathy, Unani, and Sowa-rigpa) on outcomes among individuals with prediabetes or metabolic syndrome, and T2DM. Results A total of 249 studies were included after screening 3798 citations. Most of the included studies were conducted in India and Iran. Of the 249 studies, 21 were efficacy, feasibility or pilot interventional studies. Most frequently studied CAM interventions include Ayurveda, and herbal products (58.63 %) followed by Yoga (20.88%). Unani medicines (n = 2 studies), Sowa-Rigpa (n = 1) and Homeopathy (n = 1) were the least studied modalities. With regards to population, 15 studies recruited newly diagnosed T2DM and 59 studies had included T2DM with comorbidity. Sixteen studies included population with mean ages 45-years or younger. Twenty-eight studies included pre-diabetic or metabolic syndrome, 46 studies included T2DM with no oral glycemic drugs, and 116 included T2DM with oral drugs. Blood sugars (fasting and postprandial) were the most measured outcomes. Outcomes such as HbA1c, lipid profiles, anthropometric measures, adverse effects were also assessed. Among complications, ulcer healing in diabetic foot ulcers was a commonly reported. Conclusion Future investments for research in CAM may focus on assessing the quality of existing trials and finding out an optimal dose, frequency, and duration of CAM, both as an alternative and complementary approach.