Walia Priyanka, Rohilla Latika, Dayal Devi
Endocrinology and Diabetes Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Endocrinology and Diabetes Unit, Department of Pediatrics, 3108, Level III, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India.
Diabetol Int. 2023 Sep 22;15(2):170-176. doi: 10.1007/s13340-023-00663-9. eCollection 2024 Apr.
Intermittent or concurrent use of Complementary and Alternative medicines (CAM) with insulin may have adverse effects in children with Type 1 Diabetes (T1DM). This study explores the practices of CAM use in children with T1DM.
An exploratory study was conducted among parents of children with T1DM attending a tertiary-level diabetes clinic. Data were collected using a structured pre-tested questionnaire.
Two-hundred parents were invited; 183 (91.5%) completed the study. The mean age of the children was lower among CAM users than others (7.9 ± 4.3 vs 9.3 ± 4.3 years, 0.032). The two groups were similar in gender, family income, parental education, and age at diagnosis. Sixty-seven (36.6%) had used CAM. The parents' reasoning for CAM use was to cure diabetes (62.7%), to improve glycemic control (28.3%), or considering it harmless (17.9%). The most commonly used CAMs were Ayurveda (32.8%) and homeopathic preparations (31.3%). The time interval between diagnosis and CAM use ranged from 1 day to 4 years. The duration of CAM use varied widely; 50.7% used CAM for < 1 month. Only 10 CAM users had HbA1C estimated during CAM use; their mean HbA1C was 12.4 ± 3.6%. Twenty-seven CAM users (40.2%) reported poorer glycemic control; 26.8% had no effect, and the rest had undefined effects due to too short duration of use.
CAM, mostly herbal, is frequently used among children with T1DM in North India and has detrimental effects on glycemic control. This information should be used during diabetes education to avoid medical emergencies related to sub-optimal insulin dosing.
The online version contains supplementary material available at 10.1007/s13340-023-00663-9.
补充和替代医学（CAM）与胰岛素间歇或同时使用可能对1型糖尿病（T1DM）儿童产生不良影响。本研究探讨了T1DM儿童使用CAM的情况。
对在三级糖尿病诊所就诊的T1DM儿童的家长进行了一项探索性研究。使用经过预测试的结构化问卷收集数据。
邀请了200名家长；183名（91.5%）完成了研究。CAM使用者中儿童的平均年龄低于其他儿童（7.9±4.3岁对9.3±4.3岁，P=0.032）。两组在性别、家庭收入、父母教育程度和诊断年龄方面相似。67名（36.6%）使用过CAM。家长使用CAM的理由是治愈糖尿病（62.7%）、改善血糖控制（28.3%）或认为其无害（17.9%）。最常用的CAM是阿育吠陀疗法（32.8%）和顺势疗法制剂（31.3%）。诊断与使用CAM之间的时间间隔从1天到4年不等。CAM的使用持续时间差异很大；50.7%使用CAM的时间<1个月。只有10名CAM使用者在使用CAM期间进行了糖化血红蛋白（HbA1C）评估；他们的平均HbA1C为12.4±3.6%。27名CAM使用者（40.2%）报告血糖控制较差；26.8%没有效果，其余因使用时间过短效果不明确。
在印度北部，T1DM儿童经常使用CAM，主要是草药，并且对血糖控制有不利影响。在糖尿病教育期间应利用这些信息，以避免与胰岛素剂量不足相关的医疗紧急情况。
在线版本包含可在10.1007/s13340-023-00663-9获取的补充材料。
