Abstract
BackgroundThe incidence of chronic illnesses has increased worldwide. Diabetes is one such illness and 80% of the diabetic population lives in the developing world. There is a rapidly growing trend towards the use of Complementary and Alternative Medical practices in Diabetes. Sri Lanka is a developing Asian nation with a rich culture of Ayurvedic and native medical culture.The objective of this study was to find the prevalence of use of CAMs in a diabetic population attending a large multiethnic diabetes facility in a University unit and to assess whether there is an increase in the incidence of hypoglycaemic episodes among users of CAMs.MethodsA cross sectional study was performed at Teaching Hospital Peradeniya between April and August 2012. Following verbal consent, 254 type 2 adult diabetic patients attending the diabetes facility were interviewed regarding the use of CAM and hypoglycaemia using an interviewer-administered questionnaire.ResultsOf the 252 valid results, 192 patients (76%) admitted to the use of a CAM to reduce blood glucose. Bitter gourd, ivy gourd and crepe ginger were used by 128, 113 and 92 individuals. While 19% used a single agent, 34%, 21% and 2.4% used 2,3 and more than 3 agents. The incidence of hypoglycaemia in CAM users was 21% and 16.6% in non-users. The difference was statistically not significant. (p = 0.57) Ingestion of Costus speciosus (Crepe ginger) was associated with higher incidence of hypoglycaemia (P = 0.01).Female gender was significantly associated with CAM use (p = 0.01), while the age, duration of diabetes, presence of co-morbidities and complications of diabetes failed to show a significant association.ConclusionSri Lanka has a very high use of herbal supplementation in type 2 diabetes patients. Although the overall incidence of hypoglycaemia is not increased among CAM users, crepe ginger is associated with significant hypoglycaemia and warrants further research.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6882-14-374) contains supplementary material, which is available to authorized users.
Highlights
The incidence of chronic illnesses has increased worldwide
The objective of this study was to evaluate the practice of Complementary and alternative Medicine among a group of Sri Lankan diabetics and to find out if those who use complementary and alternative medications (CAM) in addition to conventional therapy are at a greater risk of hypoglycaemia
Questionnaire comprised of questions divided into the 3 domains of demographic data, diabetes related information and information on use of complementary and alternative medicine. (CAM) Demographic data included age, gender, occupation, the diabetes related information included duration of diabetes, presence of complications, current anti-diabetic medication, last reported Fasting Plasma Glucose (FPG) and HbA1C and the presence of hypoglycaemic episodes
Summary
The incidence of chronic illnesses has increased worldwide. Diabetes is one such illness and 80% of the diabetic population lives in the developing world. There is an emerging trend worldwide for patients to use complementary and alternative medications (CAM) in an attempt to improve the outcomes of their illnesses as well as to improve general well being. The National Centre for Complementary and Alternative Medicine of the United States defines CAM as “a group of medical and health care systems, practices and products that are not presently considered to be part of conventional medicine”. These agents seem to have become an attractive option because of the lesser-perceived adverse reactions in comparison to prescription medications. CAM incorporates herbal remedies and other forms of therapy like acupuncture, faith healing, massage therapy, hypnosis and music therapy [3]
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