Use of alternative medicines in diabetes mellitus.
OBJECTIVE
Enormous advances have been made in medical care but more people are still using herbal or alternative remedies. In chronic conditions such as diabetes patients may turn to alternative remedies that have been purported to improve glycaemic control. This study surveyed diabetic and control subjects about their use of all prescribed medication, over-the-counter supplements, and alternative medications.


METHODS
Subjects were prospectively contacted in person or by telephone. Five hundred and two diabetic subjects and 201 control subjects were asked to provide details about themselves, their diabetes (for the diabetic subjects) and their use of prescribed medication, over-the-counter supplements and alternative medications. Subjects were asked to rank their assessment of the effectiveness of each medication. Costs were calculated on a per month basis from average prices obtained from five alternative health stores and five chemist shops.


RESULTS
Of the diabetic subjects, 78% were taking prescribed medication for their diabetes, 44% were taking over-the-counter supplements and 31% were taking alternative medications. Of the control subjects, 63% were taking prescribed medication, 51% were taking over-the-counter supplements, and 37% were taking alternative medications. Multivitamins, vitamin E, vitamin C, calcium and aspirin were the most commonly used over the counter supplements. Garlic, echinacea, herbal mixtures, glucosamine were the most commonly used alternative medications. Chromium was used only by diabetic subjects and then only rarely. Subjects rated the effectiveness of the alternative medications significantly lower than for prescribed medications but still thought them efficacious. Alternative medications purported to have some hypoglycaemic effect were little used by diabetic subjects. Diabetic subjects spent almost as much money on over-the-counter supplements and alternative medications together as they did on their diabetic medications.


CONCLUSIONS
One-third of diabetic patients are taking alternative medications that they consider efficacious but this is no more than in the control group. The money spent on alternative and non-prescription supplements nearly equals that spent on prescription medications. In view of the money spent in this area the time is past due to evaluate these remedies and to establish what merit they have.
Ryan
E A
EA
Department of Medicine, Division of Endocrinology and Metabolism, Muttart Diabetes Research, and Training Centre and Perinatal Research Centre, University of Alberta, Edmonton, Alberta, Canada. edmond.ryan@ualberta.ca
Pick
M E
ME
Marceau
C
C
D000416:Alberta; D016022:Case-Control Studies; D002857:Chromium; D000529:Complementary Therapies; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000191:economics / Q000628:therapy*; D011307:Drug Prescriptions; D005260:Female; D005737:Garlic; D005944:Glucosamine / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D019684:Magnoliopsida; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs; D008517:Phytotherapy; D010946:Plants, Medicinal; D012016:Reference Values; D013689:Telephone; D014815:Vitamins
D004366:Nonprescription Drugs; D014815:Vitamins; D002857:Chromium; D005944:Glucosamine