Complementary and alternative medicine for diabetes mellitus: an overview of systematic reviews

Background Many patients with diabetes mellitus report the use of CAM. Objectives To summarise and critically evaluate systematic reviews of any type of CAM for the treatment of diabetes. Methods Four electronic databases were searched to identify all relevant systematic reviews published between January 2000 and May 2011. Results Twelve systematic reviews met the inclusion criteria. These reviews evaluated the effectiveness of any type of CAM, herbal medicine, qi gong, tai chi, massage, moxibustion and yoga for the treatment and/or management of diabetes mellitus. Reviews also assessed the effectiveness of: pharmacological and lifestyle interventions to prevent or delay the onset of the disease; the effectiveness of herbal remedies and dietary supplements for glucose control; and the effectiveness of yoga‐based programmes on physiologic and anthropometrical risk profiles and related clinical outcomes. Six reviews were of high quality and six indicated high risk of bias. Eleven reviews arrived at cautious or negative conclusions. One systematic review of massage reported positive conclusions. Conclusions Evidence supporting the effectiveness of CAM as a treatment option for diabetes is scarce.     

Knowledge and Use of Complementary and Alternative Medicine among British Undergraduate Pharmacy Students

Aim: Attitudes and practice concerning complementary and alternative medicine (CAM) are currently an area of considerable importance. However, little is known about the overall importance of CAM in groups of health care professionals. Therefore, the primary objective was to analyse the knowledge about and use of CAM in an ethnically diverse student population at the London School of Pharmacy. Methods: A questionnaire was administered to students (264 completed questionnaires, response rate: 59.1%) and in-depth interviews were carried out with a sample of seven students. Results: Forty-three percent reported using at least one type of CAM during the last 12 months. The types of CAM used that were most frequently mentioned include aromatherapy, Traditional Chinese Medicine (TCM) and medicinal herbalism. TCM was reported by students of Chinese origin and by students from other ethnic backgrounds. However, Ayurvedic (Indian) medicine and medicine from Africa were only used in cultures from which the users originated. The study shows that a large number of herbal medical products were commonly reported by students of pharmacy. Conclusion The knowledge about and use of CAM is widespread among this group of future health care professionals and the students also expressed a strong interest in the topic. In-depth studies on the knowledge and use of CAM among other health care professionals and among ethnic minorities are urgently needed and may help to better manage the treatment of minor disorders as well as chronic diseases.     

National Center for Complementary and Alternative Medicine‐funded randomised controlled trials of acupuncture: a systematic review

The work of the National Center for Complementary and Alternative Medicine (NCCAM) has repeatedly been criticised. Much of this criticism relates to the past funding of studies of acupuncture. The aim of this article is to provide an independent, critical evaluation of the data produced by NCCAM‐funded RCTs of acupuncture. Relevant studies were identified using PubMed. Studies were included if they were NCCAM‐funded RCTs of acupuncture. Excluded were secondary reports of primary studies, RCTs not testing the effectiveness of acupuncture and National Institutes of Health‐funded studies not mentioning NCCAM support. One author extracted the data according to predefined criteria and assessed the risk of bias. The other authors verified these tasks. Thirteen RCTs were included, with sample sizes ranging from seven to 570. Most studies reported pain as the primary outcome. Six RCTs suggested acupuncture was effective. Seven RCTs had a low risk of bias. Numerous methodological shortcomings were identified. Many NCCAM‐funded RCTs of acupuncture have important limitations. These findings might improve future studies of acupuncture and could be considered in the ongoing debate regarding NCCAM‐funding.