Knowledge, attitude and practice of complementary and alternative medicines for diabetes

OBJECTIVES: To investigate the current status of knowledge, attitude and practice of patients with diabetes relating to complementary and alternative medicine (CAM) in an Indian community, and to determine perceptions about the use of CAM and factors influencing knowledge and usage. SETTING: Endocrine clinic of Swaroop Rani, Nehru Hospital, Allahabad, India. STUDY DESIGN: Hospital-based cross-sectional study. PARTICIPANTS: Patients with diabetes attending the clinic for the first time. SAMPLE SIZE: A sample of 493 study participants selected by systematic sampling from a population of 6094 patients with diabetes. STUDY VARIABLES: Age, socio-economic status, educational status, religion, family history of disease, knowledge and practice of CAM, reasons for using CAM, method of use and perceived relief. STATISTICAL ANALYSIS: Normal test of proportions, chi(2) test, Kolomogorov-Smirnov test. RESULTS: Awareness of CAM among patients was high (71%). High prevalence of CAM use was found (67.7%) among all participants, and 95% among participants aware of CAM, mostly using 'naturopathy' (97.3% among users). No significant gap (P>0.10) between knowledge and practice in different categories was observed. Desire for quick and additional relief was the most common perceived reason for using CAM (86.8%). Higher levels of education and socio-economic status were significant positive correlates of CAM use. Knowledge of CAM was gained mainly from friends and neighbours. About 30% of users adopted CAM without allopathic treatment earlier. Only 42.2% of users perceived some relief by using CAM. Lowering of blood sugar was the most common perceived relief. CAM, along with diet control and exercise, resulted in maximum degree of satisfaction (61.9%) experienced by users. No relief was experienced by 53.6% of users of 'naturopathy'. CONCLUSIONS AND SUGGESTIONS: Use of CAM in diabetes is highly prevalent despite high levels of disappointment after its use. In this study, we suggest the need for health education relating to CAM and self-care in diabetes. Use of CAM should be explored with patients before clinical decisions are made.