title: Disease severity is associated with the use of complementary medicine to treat or manage type-2 diabetes: data from the 2002 and 2007 National Health Interview Survey.
abstract: BACKGROUND
  The overall prevalence of complementary medicine (CM) use among adults in the United States with diabetes has been examined both in representative national samples and in more restricted populations. However, none of these earlier studies attempted to identify predictors of CM use to treat diabetes among the populations sampled, nor looked for a relationship between CM use and diabetes severity.
  
  
  METHODS
  Combining data from the 2002 and 2007 National Health Interview Survey (NHIS), we constructed a nationally representative sample of 3,978 U.S. adults aged ≥18 years with self-reported diabetes. Both the 2002 and 2007 NHIS contained extensive questions on the use of CM. We used logistic regression to examine the association between diabetes severity and overall CM use, as well as the use of specific categories of CM.
  
  
  RESULTS
  In adults with type-2 diabetes, 30.9% used CM for any reason, but only 3.4% used CM to treat or manage their type-2 diabetes versus 7.1% of those with type-1 diabetes. Among those using CM to treat/manage their type-2 diabetes, 77% used both CM and conventional prescription medicine for their diabetes. The most prevalent types of CM therapies used were diet-based interventions (35.19%, S.E. 5.11) and non-vitamin/non-mineral dietary supplements (33.74%, S.E. 5.07). After controlling for sociodemographic factors, we found that, based on a count of measures of diabetes severity, persons with the most severe diabetes had nearly twice the odds of using CM as those with less severe disease (OR=1.9, 95%CI 1.2-3.01). Persons who had diabetes 10 years or more (OR=1.66, 95%CI 1.04-3.66) and those that had a functional limitation resulting from their diabetes (OR=1.74, 95%CI 1.09-2.8) had greater odds of using CM than those not reporting these measures. No significant associations were observed between overall CM use and other individual measures of diabetes severity: use of diabetic medications, weak or failing kidneys, coronary heart disease, or severe vision problems.
  
  
  CONCLUSIONS
  Our results demonstrate that individuals with more severe diabetes are more likely to use CM independent of sociodemographic factors. Further studies are essential to determine if CM therapies actually improve clinical outcomes when used to treat/manage diabetes.
authors.affiliation: National Center for Complementary and Alternative Medicine, National Institutes of Health, 6707 Democracy Blvd, Bethesda, MD 20892-5475, USA. nahinr@mail.nih.gov
authors.forename: Richard L
authors.initials: RL
authors.lastname: Nahin
authors.forename: Danita
authors.initials: D
authors.lastname: Byrd-Clark
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stussman
authors.forename: Nilesh
authors.initials: N
authors.lastname: Kalyanaraman
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012720:Severity of Illness Index; D014481:United States; D055815:Young Adult