Abstract
AimThis study aimed to undertake a systematic review and meta-analysis of global prevalence and types of complementary and alternative medicine (CAM) use amongst adults with diabetes.MethodsNine databases, including MEDLINE and EMBASE, were searched for studies published between 2009 and 2019 which included extractable data for CAM use in adult patients with diabetes. Study characteristics, types of CAM, and overall and subgroup prevalence data in relation to CAM use were extracted. Meta-analysis of aggregate level data on prevalence and prevalence ratios (PRs) was performed using a random effects model.ResultsFrom the 38 studies included in the review, a total of 37 types of CAM and 223 types of herbs were identified. Pooled prevalence of CAM use was 51%. A wide variation in prevalence rates (predictive interval 8–93%) was observed. In the context of high heterogeneity, we found no evidence that CAM use was associated with gender, chronicity or type of diabetes. Approximately one third of patients did not disclose their use of CAM to healthcare professionals (95% PrI 25%, 97%). Herbal medicines, acupuncture, homoeopathy and spiritual healing were the common CAM types reported.ConclusionsA wide variation in prevalence of CAM use by patients with diabetes was identified. Healthcare professionals should be aware of their patients’ use of CAM to ensure treatment optimization, avoid herb–drug interactions and promote medication adherence in diabetes. Diabetic reviews and clinical guidelines should incorporate exploration of patient use of CAM as many patients do not proactively disclose the use of CAM to their healthcare professionals.RegistrationThe protocol for this study was registered with the Centre for Review and Dissemination (CRD). Protocol registration number CRD42019125036.
Highlights
The World Health Organization (WHO) estimates that over 400 million people have diabetes worldwide, and this is projected to increase to reach 592 million by 2035 [1]
Diabetes is caused by either lack of insulin production by the pancreas, when the amount of insulin produced by the pancreas is insufficient to carry out all blood glucose regulation processes, or by decreased insulin
Details of critical appraisal results are available in Supplementary Table 2
Summary
The World Health Organization (WHO) estimates that over 400 million people have diabetes worldwide, and this is projected to increase to reach 592 million by 2035 [1]. Diabetes mellitus (DM) is a chronic metabolic disorder in which blood glucose levels are higher than normal for a long period of time. These high blood glucose levels are attributed to abnormal disturbances of insulin production and/or function [5]. Diabetes is caused by either lack of insulin production by the pancreas (type 1 diabetes, T1D), when the amount of insulin produced by the pancreas is insufficient to carry out all blood glucose regulation processes, or by decreased insulin. Eur J Clin Pharmacol (2021) 77:1259–1274 sensitivity by the body cells (type 2 diabetes, T2D). Diabetes can be caused by a combination of low insulin production as well as low insulin sensitivity or be due to hormonal dysregulation in pregnancy [5]
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