Kifle Zemene Demelash
Department of Pharmacology, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
Metabol Open. 2021 May 13;10:100095. doi: 10.1016/j.metop.2021.100095. eCollection 2021 Jun.
The use of Complementary and Alternative Medicine (CAM) among diabetic patients is rising to manage diabetes mellitus (DM) and its complications. The burden of DM in developing countries coupled with a high prevalence of CAM use and its associated risks among diabetic patients. Therefore, this study aimed to assess the prevalence and predictors of CAM use among DM patients.
Diabetic patients visiting the diabetic clinics of Debre Tabor governmental hospital were invited to participate in a cross-sectional study. Interview guided self-administered questionnaire was used for data collection. Descriptive statistics like, frequency, percentage, mean, standard deviation, and median were conducted for each of the questions entered in order to detect outliers and validate data entry. Independent sample 't' test and ANOVA were used to test continuous variables and Chi-square test was used to compare categorical variables. Univariate and multivariate logistic regression were computed to identify associated factors (sex, age, religion, marital status, residence, employment status, educational level, monthly income, duration of DM, presence of DM complication, and family history of DM) of CAM use.
Out of 422 diabetic patients invited to participate in this study, a total of 395 completed the survey questionnaire with a response rate of 93.6%. The use of CAM was reported by 73.7% of diabetic patients. Patients' average age was 48.7 ± 12.6 years, with 53.2% females and 52.4% married. The odds of CAM use among older diabetic patients were higher compared to younger diabetic patients (AOR: 1.92; CI: 1.75-3.17). Compared to not married, married diabetic patients had higher odds of using CAM (AOR: 2.01; CI: 1.36-4.25). The odds of CAM use among respondents who develop diabetic complications were higher than patients without diabetic complications (AOR: 1.94; CI: 1.50-4.36). The odds of CAM use among respondents with a family history of DM were higher than participants without a family history of DM (AOR: 2.53; CI: 1.27-2.75). Among CAM users, 54.3% used CAM as a complementary treatment along with conventional medicine. Traditional healers (38.8%) were the most frequently reported source of recommendation about CAM use. The majority of CAM users 172 (59.1%) didn't disclose CAM use for their health care professionals.
The prevalence of herbal medicine use among diabetic patients was high. Age, marital status, residence, family history of DM, presence of diabetic complications, and duration of DM were found to be strong predictors of CAM use among diabetic patients. A rigorous struggle by the government, healthcare professionals, and educational institutions is required to increase the safe use of CAM by diabetic patients and to integrate modern diabetic treatment modalities with CAM therapies.
糖尿病患者中使用补充替代医学（CAM）来管理糖尿病（DM）及其并发症的情况正在增加。发展中国家糖尿病的负担，再加上CAM使用的高患病率及其在糖尿病患者中的相关风险。因此，本研究旨在评估糖尿病患者中CAM使用的患病率和预测因素。
邀请前往德布雷塔博尔政府医院糖尿病诊所就诊的糖尿病患者参与一项横断面研究。采用访谈引导的自填式问卷进行数据收集。对输入的每个问题进行描述性统计，如频率、百分比、均值、标准差和中位数，以检测异常值并验证数据录入。使用独立样本t检验和方差分析来检验连续变量，使用卡方检验来比较分类变量。计算单变量和多变量逻辑回归以确定CAM使用的相关因素（性别、年龄、宗教、婚姻状况、居住地、就业状况、教育水平、月收入、糖尿病病程、糖尿病并发症的存在以及糖尿病家族史）。
在邀请参与本研究的422名糖尿病患者中，共有395名完成了调查问卷，回复率为93.6%。73.7%的糖尿病患者报告使用了CAM。患者的平均年龄为48.7±12.6岁，女性占53.2%，已婚者占52.4%。与年轻糖尿病患者相比，老年糖尿病患者使用CAM的几率更高（调整后比值比：1.92；置信区间：1.75 - 3.17）。与未婚患者相比，已婚糖尿病患者使用CAM的几率更高（调整后比值比：2.01；置信区间：1.36 - 4.25）。发生糖尿病并发症的受访者使用CAM的几率高于无糖尿病并发症的患者（调整后比值比：1.94；置信区间：1.50 - 4.36）。有糖尿病家族史的受访者使用CAM的几率高于无糖尿病家族史的参与者（调整后比值比：2.53；置信区间：1.27 - 2.75）。在CAM使用者中，54.3%将CAM作为与传统医学相结合的辅助治疗方法。传统治疗师（38.8%）是关于CAM使用最常被提及的推荐来源。大多数CAM使用者172名（59.1%）未向其医护人员透露使用CAM的情况。
糖尿病患者中使用草药的患病率很高。年龄、婚姻状况、居住地、糖尿病家族史、糖尿病并发症的存在以及糖尿病病程被发现是糖尿病患者中CAM使用的强有力预测因素。政府、医护人员和教育机构需要进行严格努力，以增加糖尿病患者对CAM的安全使用，并将现代糖尿病治疗方式与CAM疗法相结合。
