Complementary therapies: relief from judgement by numbers?

Abstract

T Dunning. Complementary therapies: considerations for diabetes care. Pages 118– 125 Florence Brown*, * North Glasgow Hospitals University NHS Trust, Glasgow, Scotland There can be no doubt that complementary therapies (CTs) are here to stay and shouldn't be ignored simply because of a lack of evidence base. Trisha Dunning's comprehensive overview of CTs raises some interesting points. I wonder how many health care professionals enquire about CT use and, if the patient admits use, how judgemental our reaction might be? I remember a few years ago a recently diagnosed (type 1) teenager told me proudly that his diabetes had improved since he had started taking some large blue capsules sent over from Pakistan by a concerned family who wanted to help. Conflict ensued as the consultant physician recommended that he stop the capsules but the family wanted to attribute his improved glycaemic control to their intervention. We, of course, attributed improvement to the evidence-based insulin therapy and dietary recommendations. The nature of diabetes care is that the diabetic patient is judged by numbers: weight, BMI, HbA1c, lipid levels, blood pressure etc. No matter how empowered the patient, it must feel like there are some ‘numbers’ over which there is little sense of control. The use of CTs, therefore, could be seen as an act of self-empowerment. In seeking out a CT the patient has ownership, exerts control and monitors outcomes more likely to relate to psychological and spiritual as well as physical well-being. By virtue of the choice then, it is likely that beliefs about the efficacy of the treatment are held—a powerful tool in itself. Trisha Dunning's distinction that CTs are centred on health rather than disease is cause for reflection. This highlights the dilemma that health care professionals face in attempting to facilitate the achievement of ever tighter targets with an approach that acknowledges the patient as more than a collection of organs! As a well known American ‘professor of empowerment’ said, when trying out a selection of malt whiskies: ‘More research is needed’. As CT use amongst people with diabetes increases then the requirement for more sophisticated research will surely emerge.