National Center for Complementary and Alternative Medicine, National Institutes of Health, 6707 Democracy Blvd, Bethesda, MD 20892-5475, USA.
BMC Complement Altern Med. 2012 Oct 22;12:193. doi: 10.1186/1472-6882-12-193.
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.
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.
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.
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.
美国有糖尿病的成年人整体采用补充替代医学（CM）的流行率，在有代表性的全国性样本和更受限制的人群中都进行了研究。然而，这些早期研究中，没有一项试图确定在抽样人群中治疗糖尿病采用 CM 的预测因素，也没有研究 CM 采用与糖尿病严重程度之间的关系。
将 2002 年和 2007 年国家健康访谈调查（NHIS）的数据合并，我们构建了一个具有全国代表性的美国成年人样本，共 3978 名年龄在 18 岁及以上且自我报告患有糖尿病的成年人。NHIS 中都包含了广泛的补充替代医学使用问题。我们采用逻辑回归检验了糖尿病严重程度与整体 CM 采用之间的关系，以及特定 CM 类别的采用。
在患有 2 型糖尿病的成年人中，有 30.9%的人因任何原因采用 CM，但只有 3.4%的人用 CM 治疗或管理其 2 型糖尿病，而 1 型糖尿病患者的这一比例为 7.1%。在那些采用 CM 治疗/管理其 2 型糖尿病的人中，有 77%的人同时使用 CM 和常规处方药治疗糖尿病。采用最普遍的 CM 治疗类型是基于饮食的干预措施（35.19%，标准误差 5.11）和非维生素/非矿物质膳食补充剂（33.74%，标准误差 5.07）。在控制了社会人口统计学因素后，我们发现，根据糖尿病严重程度的测量指标，病情最严重的患者采用 CM 的可能性几乎是病情较轻患者的两倍（OR=1.9，95%CI 1.2-3.01）。糖尿病患病 10 年或更长时间的患者（OR=1.66，95%CI 1.04-3.66）和因糖尿病而有功能限制的患者（OR=1.74，95%CI 1.09-2.8）采用 CM 的可能性大于不报告这些措施的患者。在 CM 的整体采用与其他个别糖尿病严重程度测量指标之间，未观察到显著关联：糖尿病药物的使用、肾脏虚弱或衰竭、冠心病或严重视力问题。
我们的研究结果表明，独立于社会人口统计学因素，病情更严重的糖尿病患者更有可能采用 CM。需要进一步研究来确定在治疗/管理糖尿病时，CM 疗法的实际应用是否能改善临床结局。
