title: Description of clinical risk factor changes during naturopathic care for type 2 diabetes.
abstract: 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.
authors.affiliation: Bastyr University Research Center, 14500 Juanita Dr NE, Kenmore, WA 98028, USA. rbradley@bastyr.edu
authors.forename: Ryan
authors.initials: R
authors.lastname: Bradley
authors.forename: Eva
authors.initials: E
authors.lastname: Kozura
authors.forename: Heather
authors.initials: H
authors.lastname: Buckle
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kaltunas
authors.forename: Setareh
authors.initials: S
authors.lastname: Tais
authors.forename: Leanna J
authors.initials: LJ
authors.lastname: Standish
mesh_terms: 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
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin; D014280:Triglycerides; C517652:hemoglobin A1c protein, human