title: Use of Complementary and Alternative Medicines (CAMs) among type 2 diabetes patients in Sri Lanka: a cross sectional survey.
abstract: BACKGROUND
  The incidence of chronic illnesses has increased worldwide. Diabetes is one such illness and 80% of the diabetic population lives in the developing world. There is a rapidly growing trend towards the use of Complementary and Alternative Medical practices in Diabetes. Sri Lanka is a developing Asian nation with a rich culture of Ayurvedic and native medical culture. The objective of this study was to find the prevalence of use of CAMs in a diabetic population attending a large multiethnic diabetes facility in a University unit and to assess whether there is an increase in the incidence of hypoglycaemic episodes among users of CAMs.
  
  
  METHODS
  A cross sectional study was performed at Teaching Hospital Peradeniya between April and August 2012. Following verbal consent, 254 type 2 adult diabetic patients attending the diabetes facility were interviewed regarding the use of CAM and hypoglycaemia using an interviewer-administered questionnaire.
  
  
  RESULTS
  Of the 252 valid results, 192 patients (76%) admitted to the use of a CAM to reduce blood glucose. Bitter gourd, ivy gourd and crepe ginger were used by 128, 113 and 92 individuals. While 19% used a single agent, 34%, 21% and 2.4% used 2,3 and more than 3 agents. The incidence of hypoglycaemia in CAM users was 21% and 16.6% in non-users. The difference was statistically not significant. (p = 0.57) Ingestion of Costus speciosus (Crepe ginger) was associated with higher incidence of hypoglycaemia (P = 0.01).Female gender was significantly associated with CAM use (p = 0.01), while the age, duration of diabetes, presence of co-morbidities and complications of diabetes failed to show a significant association.
  
  
  CONCLUSIONS
  Sri Lanka has a very high use of herbal supplementation in type 2 diabetes patients. Although the overall incidence of hypoglycaemia is not increased among CAM users, crepe ginger is associated with significant hypoglycaemia and warrants further research.
authors.affiliation: Department of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. arjuna.medagama@gmail.com.
authors.forename: Arjuna B
authors.initials: AB
authors.lastname: Medagama
authors.forename: Ruwanthi
authors.initials: R
authors.lastname: Bandara
authors.forename: Rajitha A
authors.initials: RA
authors.lastname: Abeysekera
authors.forename: Buddhini
authors.initials: B
authors.lastname: Imbulpitiya
authors.forename: Thamudika
authors.initials: T
authors.lastname: Pushpakumari
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000706:statistics & numerical data*; D010946:Plants, Medicinal; D013188:Sri Lanka / Q000453:epidemiology