Complementary and alternative medicine use among patients with type-2 diabetes mellitus attending a suburban tertiary healthcare centre in Sri Lanka.

Abstract

Background: Type 2 diabetes mellitus (T2DM) represents a major global health problem with significant complications and high economic and social burdens, leading many patients to explore complementary and alternative medicine (CAM) for obtaining relief. This study was conducted to explore the use of CAM by patients with T2DM and factors influencing it.

Methods: A cross-sectional study was conducted at a suburban tertiary care hospital in Sri Lanka using 280 randomly selected patients diagnosed with T2DM. Data were collected using an interviewer-administered questionnaire adapted using published instruments. The questionnaire included open-ended questions on types of CAM used, a five-point Likert scale that assessed attitudes and beliefs and questions assessing knowledge and perceptions. Ethics approval was received from the Faculty of Medicine, Wayamba University of Sri Lanka (PW/2024/02/01). The data analysis used the chi-square and independent sample t- tests at a 0.05 significance level.

Results: The majority were females (87.5%), and 64.6% were > 60 years of age. The prevalence of CAM use was 68.6%, and 35.5% used it as a treatment for controlling diabetes concurrently with conventional medicine, while 4.5% used CAM concurrently with conventional medicine for improving their well-being. Orally consumed herbal remedies were the commonest CAM used (30.4%), followed by spiritual healing (19.1%) and music therapy (13.1%). Some used more than one type of CAM. Bitter gourd fruit (Momordica charantia), canerreed leaves (Costus speciosus) and fenugreek seeds (Trigonella foenum) were the most common herbs used. 52.1% demonstrated a lack of specific knowledge that would be required to enquire about the safety, efficacy and possible interactions with medications used concurrently. No significant association was observed between CAM use and sociodemographic characteristics or disease-related factors.

Conclusions: There was widespread use of CAM by patients with T2DM. Future research with larger and diverse populations is recommended to explore CAM usage in more depth. Controlled trials for commonly used CAM therapies with or without simultaneous use of conventional medications are needed to assess effectiveness, safety and possible drug interactions. There is a need to work towards formally integrating CAM and conventional medicine for improved patient satisfaction while ensuring safety and therapeutic benefits.