COMPLEMENTARY AND ALTERNATIVE MEDICINES

Many people with diabetes either take or have considered taking so-called "complementary or alternative medicines" (called "CAM's" for short). Is it a good idea to take such treatment? Well, it all depends. Some substances might be good, some might be neutral and some might be very bad indeed. To assist you with making an informed choice (can you tell that I subscribe to Consumer Reports?) I'd suggest you start your investigations by having a look at:

  • Dr. Jeannette Goguen's article (displayed below). She works at the University of Toronto and has kindly allowed me to reproduce her note on this web site.
  • Health Canada's Canadian Adverse Reaction Newsletter. This is a professional publication, but the issue (entitled "Adverse reactions to natural health products") of October, 2002 is excellent reading for both lay and physician audiences and I would heartily recommend having a look at it:

I commonly get asked if it is necessary to take vitamin and/or mineral supplements. My feeling has been that if one eats a well-balanced diet and follows current diabetes nutrition guidelines (such as provided by Health Canada), vitamin supplements generally do little except give you expensive urine. Note that this advice regarding vitamins does not apply to pregnant women (wherein taking a multivitamin and folic acid is recommended) nor does it apply to the elderly, strict vegetarians, or to those many Canadians who, because of insufficient sun exposure or risk of osteoporosis, need vitamin D and/or calcium supplements,
 
So am I a sceptic when it comes to alternative & complementary therapy? You bet. And am I a sceptic when it comes to the newest prescription medication? You bet. Let's see the evidence, shall we? If a treatment (prescription, alternative, whatever) is new, it must stand both scientific scrutiny and "the test of time." And that's my soap box for the moment.


SHOULD YOU USE ALTERNATIVE MEDICINE FOR BLOOD SUGAR CONTROL IN DIABETES MELLITUS?

Alternative medicine is medicine that is not traditionally taught about in medical schools, and is not used by conventional doctors. This is because in most cases the effectiveness of alternative agents is not scientifically proven. Despite this lack of proof, there are many substances used by practitioners of alternative medicine for patients with diabetes. Studies have been done for a few of these substances in current use to determine if they can truly improve blood sugar control. There are encouraging preliminary results for some substances (e.g., chromium, American ginseng and the soluble fiber Konjac-Mannan), however at this point there is no firm evidence that any alternative medicine can lower blood sugar (see reference below).

I believe it is premature to start using alternative substances to treat high blood sugar for the following reasons:

  • There is no proof that any alternative agent works for long term blood sugar control.
  • Side effects and toxicities of alternative medicines are still largely unknown.
  • There is the possibility of a bad drug reaction if alternative medications are mixed with conventional medications.
  • The strength and purity of alternative agents can vary greatly from bottle to bottle. Currently, there is no government agency in Canada monitoring them. For example, in one study, up to 30% of traditional Chinese medicine contained heavy (toxic) metals and/or conventional medications that were not on the label.

If you do decide to take alternative medicine, please tell your doctors so that they can try to check if they interact with any of your other medications.

Jeannette Goguen, MD, FRCPC
Staff Endocrinologist
St. Michael's Hospital
Toronto, Ontario

For more details, see alternative medicine: The role of selected minerals, vitamins, fiber, and herbs in treating hyperglycemia Jeannette Goguen and Lawrence Leiter in Evidence-based Diabetes Care. Ed H. Gerstein and RB Haynes, BC Decker Inc Hamilton 2001