|ISSN No. 1606-7754 Vol.17 No.1 April 2009|
A survey amongst Complementary Alternative Medicine (CAM) users with type 2 diabetes
Hasniza Zaman Huri1, Grace Tan Poh Lian1, Samsinah Hussain1, Rokiah Pendek,2 Riyanto Teguh Widodo1
Department of Pharmacy1, Department of Medicine2, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Background: This survey studied the different types of Complementary Alternative Medicine (CAM) usage, the reasons of CAM usage and the out-of-pocket expenditure incurred by CAM users with Type 2 diabetes. Methods: This was a descriptive, cross-sectional survey that involved 132 Type 2 diabetes patients. Results: A total of 30.2% of the patients used dietary supplements, followed by traditional Chinese medicine (TCM) (25.1%) and traditional Malay medicine (17.9%). Two main reasons for using CAM include: the need of patients for more control of their diabetes and also dissatisfaction with conventional medicine. More than half of the patients spent around USD 7.2 to USD 13.9 per month on CAM as an out-of-pocket expenditure. Less than 20% of the patients consult their physicians before using CAM. About 57% of patients stated that their diabetes control did not show any improvement or worsen after CAM usage. Conclusion: CAM was widely used among Type 2 diabetics as an adjunct to their conventional therapy. More than half of the patients found that CAM did not give improvement nor worsens their diabetes control. CAM was one of the alternative treatments considered by Type 2 diabetes patients in complement with the conventional treatment for their diabetes control.
Keywords: Bleeding time, diabetes, gender
Diabetes mellitus is a chronic debilitating medical condition that affects about 33, 000 individuals in Malaysia and 300 cases of death were caused by this disease in year 2002. Diabetes mellitus is prevalent in Malaysia and has shown an increasing trend from 1996 to 2002. The number of diabetics in Malaysia is expected to double by the year 2010.1 Over 90% of those with diabetes have Type 2 diabetes, including those with at young age.1
Advances in the management of diabetes mellitus in the form of new drugs, new sources of insulin and new approaches to practices are recommended for physicians.2 However, the growing utilization of complementary and alternative medicine (CAM) represents one of the characteristic phenomenons facing scientific medicine. Public interest in the use of CAM is on the rise. The use of CAM in the management of chronic disease is well known in developed countries and is practiced to some extent in industrialized countries. Diabetic patients are more likely to use CAM because of the chronic course of the disease.
A large number of CAM treatments have been recommended for diabetes. Various degree of hypoglycemic effects have been attributed to most of these agents.3 However, the efficacy of most CAM therapy for glucose control and diabetes management is unproven.4 In general, the scientific literature on the efficacy of CAM in the treatment of diabetes is relatively sparse and diverse.
High rates of CAM use are well documented in the general population without clear clinical benefits.5 In fact, there are conflicting reports in the literature about the benefits of CAM and reports of adverse outcomes from the use of CAM in people with diabetes have raised several concerns.6 A major concern is that people with diabetes may use CAM agents in place of clinically proven conventional diabetes treatment.3 Another concern is the risk of drug interaction when these agents are used as complements to conventional treatment. Finally, there is concern that some of these agents may worsen glycemic control or even create additional complications for people with diabetes.3
Therefore this survey was conducted to improve the awareness of the usage of CAM among adult diabetes patients. The study also examined the following specific objectives: