Description of clinical risk factor changes during naturopathic care for type 2 diabetes.
BACKGROUND
Survey findings report that 48% of people with type 2 diabetes use complementary and alternative medicine (CAM) practice. Publications suggest a high incidence of health promotion counseling in naturopathic practice, yet clinical data on risk factor changes are not available in the literature.


OBJECTIVE
The primary aim of this study was to describe clinical risk factor changes during the utilization of naturopathic CAM services in patients with type 2 diabetes.


METHODS
A retrospective, observational study design was used to describe naturopathic care.


METHODS
Abstracted medical charts were from patients of the Bastyr Center for Natural Health in Seattle, WA.


METHODS
The patients in this study had type 2 diabetes and received naturopathic care between 2001 and 2006.


RESULTS
Abstracted data included patient demographics, duration of care, number of visits, laboratory values for hemoglobin A1c (HbA1c), low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol, triglycerides (TAG); and systolic/diastolic blood pressure (SPB, DBP).


RESULTS
Thirty-seven (37) patient records met inclusion criteria and were abstracted in detail. Mean and median duration of care were 27 and 20 months, respectively. The mean number of visits was 11. Significant mean changes in clinical laboratory risk factors over the duration of care were: -0.65% for HbA1c (p = 0.046), -45 mg/dL for TAG (p = 0.037), -7 mm Hg in SBP (p = 0.02), and -5 mm Hg in DBP (p = 0.003). Mean changes for cholesterol did not reach statistical significance. The percentage of patients who reached new control, had clinically significant risk factor improvements, or had any improvement was: 26%, 42%, and 68% for HbA1c, 7%, 28%, and 62% for LDL, 0%, 25%, and 39% for HDL, 14%, 38%, and 52% for TAG, 16%, 51%, and 86% for SBP, and 27%, 54%, and 70% for DBP. COMMENTS/CONCLUSIONS: These preliminary outcomes suggest that risk factor improvements occur during naturopathic care for diabetes, although the contribution of naturopathic care to these changes cannot be determined. Effectiveness and generalizability of naturopathic approaches in treating type 2 diabetes should be evaluated in controlled prospective studies in representative populations or randomized trials.
Bradley
Ryan
R
Bastyr University Research Center, 14500 Juanita Dr NE, Kenmore, WA 98028, USA. rbradley@bastyr.edu
Kozura
Eva
E
Buckle
Heather
H
Kaltunas
Jennifer
J
Tais
Setareh
S
Standish
Leanna J
LJ
D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009324:Naturopathy; D010044:Outpatient Clinics, Hospital; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D002784:Cholesterol; D006442:Glycated Hemoglobin; D014280:Triglycerides; C517652:hemoglobin A1c protein, human