Abstract

BackgroundPatients with Type 2 Diabetes Mellitus (T2DM) are increasingly using complementary and alternative medicine (CAM) therapies due to difficulty in adhering to the therapeutic regimens and lifestyle changes necessary for disease management. Little is known about the prevalence and mode of CAM use among patients with T2DM in Lebanon.ObjectiveTo assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon.MethodsA cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers in Beirut- a public hospital and a private academic medical center. In a face-to-face interview, participants completed a questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence and correlates of CAM use, as well as whether the use was complementary or alternative to mainstream medicine. The main outcome in this study, CAM use, was defined as using CAM at least once since diagnosis with T2DM.ResultsA total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use since diagnosis with the disease was 38%. After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as alternative to conventional treatment. Only 7% of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users.ConclusionThe use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those who have had the disease for a long time.

Highlights

  • Patients with Type 2 Diabetes Mellitus (T2DM) are increasingly using complementary and alternative medicine (CAM) therapies due to difficulty in adhering to the therapeutic regimens and lifestyle changes necessary for disease management

  • Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those who have had the disease for a long time

  • The results of the multivariate model showed that CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications (OR: 1.71; 95% CI: 1.3-3.51), and a positive family history of the disease (OR: 1.15; 95% CI: 1.02-1.30)

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Summary

Introduction

Patients with Type 2 Diabetes Mellitus (T2DM) are increasingly using complementary and alternative medicine (CAM) therapies due to difficulty in adhering to the therapeutic regimens and lifestyle changes necessary for disease management. Several epidemiological studies in the Eastern Mediterranean Region (EMR) have reported high prevalence of Type-2 Diabetes Mellitus (T2DM) and impaired glucose intolerance [1,3,4,5]. The EMR has a diabetes prevalence that is among the highest in the world with an estimated 9.2% of the adult population having the disease [5]. The prevalence of T2DM among adults in Lebanon (15.8%) is lower than that reported in many other EMR countries, including Bahrain (25.5%), UAE (23.3%) and KSA (23.7%) [6,7]. Researchers are alarmed by the increasing trend in prevalence of T2DM over time, since this prevalence in the country has increased by 36% in a five-year period, from 11.6% in 1999 to 15.8% in 2004 [6,8]

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