Reasons for Concern
Two major reasons for concern with CAM use include the potential for side effects and/or drug interactions. Other concerns include problems with standardization and misidentification or mislabeling of ingredients. There may be an increased indirect cost of diabetes care because patients may substitute ineffective complementary therapies for proven therapeutic agents. These costs may include increased hospitalizations, acute complications such as ketoacidosis, acute hyperglycemia, or chronic complications such as retinopathy. Other potential costs include decreased work productivity and diminished ability to function in a social or occupational setting.
Sometimes there are claims made by manufacturers of CAM that should be viewed cautiously. These include the following:
- Claims made using "borrowed science" that is borrowed from different sources.
- Misrepresenting data - information that is partially accurate, but the individuals making the claim may "bend the truth" to meet their needs.
- Stating research is "underway."
- Using testimonials, which are not evidence-based medicine.
- Providing poorly designed research available or research available only in abstract form.
- Promoting their patent; it has no safety or efficacy claims.
CAM products include botanical and non-botanical products to lower blood glucose or treat complications of diabetes. Botanical products used to lower blood glucose include Gymnema sylvestre, fenugreek (Trigonella foenum-graecum), bitter melon (Momordica charantia), ginseng (Panax ginseng), and nopal ("prickly pear" or Opuntia streptacantha). Claims have also been made for aloe, bilberry, and milk thistle (Silybum marianum) but there is less evidence. Non-botanical products thought to lower blood glucose include chromium, vanadium, CoQ10, and nicotinamide. Products thought to decrease complications include alpha lipoic acid, gamma linolenic acid, ginkgo biloba, and garlic, as well as Vitamin E and magnesium.
Complementary and Alternative Medicine Pages:
Main | Concerns | Gymnema Sylvestre | Fenugreek | Bitter Melon | Ginseng | Nopal | Aloe, Bilberry, and Milk Thistle | Chromium | Vanadium | CoQ10 | Nicotinamide | Alpha Lipoic Acid | Gamma Linolenic Acid | Ginkgo Biloba | Garlic | Advice | Additional Reading | References
Laura Shane-McWhorter, PharmD, BCPS, FASCP, CDE, BC-ADM
November 24, 2001
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