Complementary and alternative medicine use among Turkish diabetes patients

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Summary

Objectives

To measure the frequency of complementary and alternative medicine (CAM) use among patients with diabetes mellitus, to determine demographic characteristics making it more likely to using CAM, and to find out how benefits, if any, were perceived by patients.

Design

A 24-item survey questionnaire administered to 371 return patients with diabetes mellitus.

Setting

Outpatient clinic of the Department of Endocrinology and Metabolism department of Gülhane Military Medical Academy, Ankara, Turkey.

Main outcome measures

Questionnaire-based measures of demographics, motives, expectations, and effects of using CAM, and types and reported perceived benefits of CAM practiced on patients with diabetes mellitus.

Results

Forty-one percent of patients (n = 152) used at least one of CAM practices; and age, birthplace, educational status, duration of diabetes and family type were significant factors in such behaviour.

Conclusions

Patients born in cities, having more education and longer duration of diabetes, at relatively young ages and living in large families were more likely to use CAM. More than half of those using CAM (n = 80, 52.7%) reported as benefits the feelings of either strengthening of body, or being in good psychological condition, or disappearance of several symptoms.

Introduction

Interest in and use of complementary and alternative medicine (CAM) has recently grown in many countries around the World.1 Population-based studies in countries in the developed world, such as Australia,2 UK,3 Taiwan,4 Singapore5 and the United States of America,6 report that one-half to two-thirds of adults use CAM.

As there are many factors, such as the socio-cultural and personal values underlying a person's decision to use alternative therapies, at present, there is no clear or comprehensive theoretical model to account for the increased use of alternative forms of health care.7

Because of the potential threat to quality of life and the chronic nature of diabetes, many people turn to complementary therapies (CTs) to assist them in coping with and controlling the disease. That they do so is not unexpected, since many people with chronic diseases utilize CTs.8

Studies that examine complementary therapy usage rates by diabetics have notably different results. Leese et al.9 surveyed people with diabetes attending a diabetic outpatient clinic in the UK and found 17% were using CT. A similar survey in Canada found 25% of people with diabetes used CT.10 A nation-wide survey in the USA found people with diabetes were 1.6 times more likely to use a CT than non-diabetics, but the pattern of use was similar in both groups.11 The most widely used therapies among diabetic populations are nutritional supplements, herbal medicines, nutritional advice, and spiritual healing and relaxation techniques.1

Medical practice in Turkey (and Anatolia specifically) date back to ancient times.12 In modern times, CAM, as passed on from earlier times, exist in parallel with conventional medicine. CAM in Turkey is practiced almost exclusively by people not versed in conventional medicine. CAM practices cover a wide spectrum ranging from herbal prescriptions to religious practices.13

In Turkey, many studies have been carried out on the applications of CAM. However, almost all of them involve patients with malignancies. After publishing the first study in 2002, the extent and patterns of CAM use among patients with malignancies were studied. According to results of these studies, the prevalence of CAM use among people with malignancies range from 36% to 61%.14, 15, 16, 17 Although there were a few studies focused on general CAM use, the authors of the present study could find no particular study carried out among only patients with DM in Turkey.

The purpose of this study is to measure the frequency of CAM use in patients with diabetes while undergoing or after undergoing conventional treatment, to determine the demographic characteristics that make it more likely to use CAM, and to find out how such patients perceive the benefits, if any, from the use of CAM.

Section snippets

Material and methods

This is a cross-sectional study on patients admitted to the outpatient clinic of the Department of Endocrinology and Metabolism at the Gülhane Military Medical Academy (GMMA), Ankara, Turkey from January 2006 to December 2006.

Results

The data collected from 371 patients are charted in Table 1 by demographic characteristics. Forty-one percent of patients (n = 152) used at least one type of CAM practices.

Sex, marital status and age groups proved not to be significant factors (p > 0.05 in each case). The mean duration of diabetes of the patients was 9.1 ± 7.5 years, and ranged from 1 year to 36 years. A significant difference (p < 0.05) was found among the patients with a time interval of 1–5 years, 6–10 years and 11 years or more

Discussion

Many studies were conducted on patients with DM who use complementary or alternative methods. Chang and colleagues cited a total of 18 studies from nine countries and reported that the frequency of using complementary/alternative methods varied between 17% and 72.8% for the patients with DM.1 The rate of 41% that we found in this study is close to the average of the findings of earlier studies.

Complementary and alternative medicine practices have been widespread in Anatolia for centuries and

Acknowledgements

We would like to thank all survey respondents in this study and wish them well. I am especially grateful to the staff of Department of Endocrinology and Metabolism at the Gülhane Military Medical Academy, Ankara, Turkey for their earnest support and accommodation for this study.

References (24)

  • J.A. Astin

    Why patients use alternative medicine?

    Journal of the American Medical Association

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  • G. Leese et al.

    Prevalence of complementary medicine usage within a diabetic clinic

    Practical Diabetes International

    (1997)
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