Abstract
It has been reported that up to 70% of patients with type 2 diabetes mellitus (T2DM) use complementary and alternative medicine (CAM) each year. Healthcare providers refer to clinical practice guidelines (CPGs) in order to assist patients in making evidence-based decisions, however, no resource currently systematically summarizes CAM-related recommendations across CPGs for the treatment and/or management of T2DM. The purpose of this study was to identify all CPGs that make CAM-related recommendations and summarize them in a single review. We conducted a systematic search of MEDLINE, EMBASE, and CINAHL databases, as well as the Guidelines International Network and National Center for Complementary and Integrative Health websites, to identify CPGs for the treatment and/or management of T2DM published between 2009 and 2020, inclusive. Two independent reviewers conducted a data extraction of types of CAM mentioned and how they were recommended across all eligible CPGs. Of 2607 unique search results, 27 CPGs were eligible, and 7 included CAM therapy recommendations. Recommendations relating to CAM made in these 7 CPGs included (number of recommendations in total; for/against/uncertain): cardioprotective diet (1;1/0/0), cognitive behavioural therapy (1;1/0/0), diet emphasizing dietary pulses (1;1/0/0), diet emphasising fruits and vegetables (1;1/0/0), diet emphasizing nuts (1;1/0/0), Dietary Approaches to Stop Hypertension (DASH) diet (2;2/0/0), folic acid (1;1/0/0), goal setting skills (1;1/0/0), herbs (1;0/0/1), Mediterranean diet (3;3/0/0), motivational interviewing (1;1/0/0), omega-3 (2;0/1/1), plant-based preparations (1;1/0/0), potassium (1;1/0/0), selenium (1;0/0/1), vegan/vegetarian diet (1;1/0/0), vitamin A (1;0/0/1), vitamin C (1;0/0/1), vitamin D3 (1;1/0/0), vitamin E (2;0/1/1), vitamin/micronutrient supplementation (1;0/1/0), and yoga (1;1/0/0). CAM therapies for T2DM are only represented in approximately one-quarter of CPGs. Given that a high proportion of T2DM patients use CAM, current T2DM CPGs’ neglect of CAM treatment and/or management highlights a major gap in guidance for clinicians and patients.
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