Disease severity is associated with the use of complementary medicine to treat or manage type-2 diabetes: data from the 2002 and 2007 National Health Interview Survey

BMC Complementary and Alternative Medicine

Nilesh Kalyanaraman²  Barbara J Stussman²  Danita Byrd-Clark¹  Richard L Nahin² 

[1] Social & Scientific Systems, Inc, 8757 Georgia Avenue, Silver Spring, MD, 20910, USA;National Center for Complementary and Alternative Medicine, National Institutes of Health, 6707 Democracy Blvd, Bethesda, MD, 20892-5475, USA

关键词: Survey;    Logistic regression;    Disease severity;    Diabetes;    Complementary medicine;   

Others  :  1231528
DOI  :  10.1186/1472-6882-12-193

 received in 2012-02-06, accepted in 2012-10-11,  发布年份 2012

【 摘 要 】

Background

The overall prevalence of complementary medicine (CM) use among adults in the United States with diabetes has been examined both in representative national samples and in more restricted populations. However, none of these earlier studies attempted to identify predictors of CM use to treat diabetes among the populations sampled, nor looked for a relationship between CM use and diabetes severity.

Methods

Combining data from the 2002 and 2007 National Health Interview Survey (NHIS), we constructed a nationally representative sample of 3,978 U.S. adults aged ≥18 years with self-reported diabetes. Both the 2002 and 2007 NHIS contained extensive questions on the use of CM. We used logistic regression to examine the association between diabetes severity and overall CM use, as well as the use of specific categories of CM.

Results

In adults with type-2 diabetes, 30.9% used CM for any reason, but only 3.4% used CM to treat or manage their type-2 diabetes versus 7.1% of those with type-1 diabetes. Among those using CM to treat/manage their type-2 diabetes, 77% used both CM and conventional prescription medicine for their diabetes. The most prevalent types of CM therapies used were diet-based interventions (35.19%, S.E. 5.11) and non-vitamin/non-mineral dietary supplements (33.74%, S.E. 5.07). After controlling for sociodemographic factors, we found that, based on a count of measures of diabetes severity, persons with the most severe diabetes had nearly twice the odds of using CM as those with less severe disease (OR=1.9, 95%CI 1.2-3.01). Persons who had diabetes 10 years or more (OR=1.66, 95%CI 1.04-3.66) and those that had a functional limitation resulting from their diabetes (OR=1.74, 95%CI 1.09-2.8) had greater odds of using CM than those not reporting these measures. No significant associations were observed between overall CM use and other individual measures of diabetes severity: use of diabetic medications, weak or failing kidneys, coronary heart disease, or severe vision problems.

Conclusions

Our results demonstrate that individuals with more severe diabetes are more likely to use CM independent of sociodemographic factors. Further studies are essential to determine if CM therapies actually improve clinical outcomes when used to treat/manage diabetes.

【 授权许可】

   
2012 Nahin et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]American Diabetes Association: Standards of medical care in diabetes--2011. Diabetes Care 2011, 34(1):S11-S61.
• [2]DAFNE Study Group: Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomised controlled trial. BMJ 2002, 325:746.
• [3]Gaede P, Valentine WJ, Palmer AJ, Tucker DM, Lammert M, Parving HH, Pedersen O: Cost-effectiveness of intensified versus conventional multifactorial intervention in type-2 diabetes: results and projections from the Steno-2 study. Diabetes Care 2008, 31:1510-1515.
• [4]Brownson CA, Hoerger TJ, Fisher EB, Kilpatrick KE: Cost-effectiveness of diabetes self-management programs in community primary care settings. Diabetes Educ 2009, 35:761-769.
• [5]Hernandez CA, Bradish GI, Rodger NW, Rybansky SI: Self-awareness in diabetes: using body cues, circumstances, and strategies. Diabetes Educ 1999, 25:576-584.
• [6]Paterson B, Thorne S: Expert decision making in relation to unanticipated blood glucose levels. Res Nurs Health 2000, 23:147-157.
• [7]Arcury TA, Bell RA, Snively BM, Smith SL, Skelly AH, Wetmore LK, Quandt SA: Complementary and alternative medicine use as health self-management: rural older adults with diabetes. J Gerontol B Psychol Sci Soc Sci 2006, 61:S62-S70.
• [8]Hunt LM, Arar NH, Akana LL: Herbs, prayer, and insulin. Use of medical and alternative treatments by a group of Mexican American diabetes patients. J Fam Pract 2000, 49:216-223.
• [9]Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL: Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 1993, 328:246-252.
• [10]Astin JA: Why patients use alternative medicine: results of a national study. JAMA 1998, 279:1548-1553.
• [11]Yeh GY, Eisenberg DM, Davis RB, Phillips RS: Use of complementary and alternative medicine among persons with diabetes mellitus: results of a national survey. Am J Public Health 2002, 92:1648-1652.
• [12]Bell RA, Suerken CK, Grzywacz JG, Lang W, Quandt SA, Arcury TA: Complementary and alternative medicine use among adults with diabetes in the United States. Altern Ther Health Med 2006, 12:16-22.
• [13]Garrow D, Egede LE: National patterns and correlates of complementary and alternative medicine use in adults with diabetes. J Altern Complement Med 2006, 12:895-902.
• [14]Graham RE, Ahn AC, Davis RB, O’Connor BB, Eisenberg DM, Phillips RS: Use of complementary and alternative medical therapies among racial and ethnic minority adults: results from the 2002 National Health Interview Survey. J Natl Med Assoc 2005, 97:535-545.
• [15]Nahin RL, Dahlhamer JM, Taylor BL, Barnes PM, Stussman BJ, Simile CM, Blackman MR, Chesney MA, Jackson M, Miller H, McFann KK: Health behaviors and risk factors in those who use complementary and alternative medicine. BMC Publ Health 2007, 7:217. BioMed Central Full Text
• [16]Barnes PM, Powell-Griner E, McFann K, Nahin RL: Complementary and alternative medicine use among adults: United States, 2002. Adv Data 2004, 343:1-19.
• [17]Barnes PM, Bloom B, Nahin RL: Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report 2008, 12:1-23.
• [18]Schuster TL, Dobson M, Jauregui M, Blanks RH: Wellness lifestyles I: A theoretical framework linking wellness, health lifestyles, and complementary and alternative medicine. J Altern Complement Med 2004, 10:349-356.
• [19]Bair YA, Gold EB, Greendale GA, Sternfeld B, Adler SR, Azari R, Harkey M: Ethnic differences in use of complementary and alternative medicine at midlife: longitudinal results from SWAN participants. Am J Public Health 2002, 92:1832-1840.
• [20]Cheung CK, Wyman JF, Halcon LL: Use of complementary and alternative therapies in community-dwelling older adults. J Altern Complement Med 2007, 13:997-1006.
• [21]Gray CM, Tan AW, Pronk NP, O’Connor PJ: Complementary and alternative medicine use among health plan members. A cross-sectional survey. Eff Clin Pract 2002, 5:17-22.
• [22]Downey L, Tyree PT, Lafferty WE: Preventive screening of women who use complementary and alternative medicine providers. J Womens Health (Larchmt) 2009, 18:1133-1143.
• [23]Harris MI, Cowie CC, Howie LJ: Self-monitoring of blood glucose by adults with diabetes in the United States population. Diabetes Care 1993, 16(8):1116-1123.
• [24]Ford ES, Malarcher AM, Herman WH, Aubert RE: Diabetes mellitus and cigarette smoking. Findings from the 1989 National Health Interview Survey. Diabetes Care 1994, 17(7):688-692.
• [25]Young BA, Lin E, Von Korff M, Simon G, Ciechanowski P, Ludman EJ Everson-Stewart S, Kinder L, Oliver M, Boyko EJ, Katon WJ: Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. Am J Manag Care 2008, 14(1):15-23.
• [26]Rosenzweig JL, Weinger K, Poirier-Solomon L, Rushton M: Use of a disease severity index for evaluation of healthcare costs and management of comorbidities of patients with diabetes mellitus. Am J Manag Care 2002, 8(11):950-958.
• [27]Linzer M, Pierce C, Lincoln E, Miller DR, Payne SM, Clark JA, Skinner KM, Greenfield S, Kaplan S, McHorney CA, Lee A, Kazis LE: Preliminary validation of a patient-based self-assessment measure of severity of illness in type 2 diabetes: results from the pilot phase of the Veterans Health Study. J Ambul Care Manage 2005, 28(2):167-176.
• [28]Maddigan SL, Majumdar SR, Toth EL, Feeny DH, Johnson JA, DOVE Investigators: Health-related quality of life deficits associated with varying degrees of disease severity in type 2 diabetes. Health Qual Life Outcomes 2003, 1:78-88. BioMed Central Full Text
• [29]Pan A, Lucas M, Sun Q, van Dam RM, Franco OH, Manson JE, Willett WC, Ascherio A, Hu FB: Bidirectional association between depression and type 2 diabetes mellitus in women. Arch Intern Med 2010, 170(21):1884-1891.
• [30]Renn BN, Feliciano L, Segal DL: The bidirectional relationship of depression and diabetes: a systematic review. Clin Psychol Rev 2011, 31(8):1239-1246.
• [31]Nahin RL, Dahlhamer JM, Stussman BJ: Health need and the use of alternative medicine among adults who do not use conventional medicine. BMC Health Serv Res 2010, 10:220.
• [32]Schunk M, Reitmeir P, Schipf S, Völzke H, Meisinger C, Thorand B, Kluttig A, Greiser KH, Berger K, Müller G, Ellert U, Neuhauser H, Tamayo T, Rathmann W, Holle R: Health-related quality of life in subjects with and without Type 2 diabetes: pooled analysis of five population-based surveys in Germany. Diabet Med 2012, 29(5):646-653.
• [33]Schipf S, Werner A, Tamayo T, Holle R, Schunk M, Maier W, Meisinger C, Thorand B, Berger K, Mueller G, Moebus S, Bokhof B, Kluttig A, Greiser KH, Neuhauser H, Ellert U, Icks A, Rathmann W, Völzke H: Regional differences in the prevalence of known Type 2 diabetes mellitus in 45-74 years old individuals: Results from six population-based studies in Germany (DIAB-CORE Consortium). Diabet Med 2012, 29(7):e88-e95.
• [34]Liese AD, D’Agostino RB Jr, Hamman RF, Kilgo PD, Lawrence JM, Liu LL, Loots B, Linder B, Marcovina S, Rodriguez B, Standiford D, Williams DE, SEARCH for Diabetes in Youth Study Group: The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. Pediatrics 2006, 118(4):1510-1518.
• [35]Bays HE, Bazata DD, Clark NG, Gavin JR 3rd, Green AJ, Lewis SJ, Reed ML, Stewart W, Chapman RH, Fox KM, Grandy S: Prevalence of self-reported diagnosis of diabetes mellitus and associated risk factors in a national survey in the US population: SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes). BMC Publ Health 2007, 7:277. BioMed Central Full Text
• [36]Bell RA, Mayer-Davis EJ, Beyer JW, D’Agostino RB Jr, Lawrence JM, Linder B, Liu LL, Marcovina SM, Rodriguez BL, Williams D, Dabelea D, SEARCH for Diabetes in Youth Study Group: Diabetes in non-Hispanic white youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study. Diabetes Care 2009, 32(Suppl 2):S102-S111.
• [37]Mayer-Davis EJ, Beyer J, Bell RA, Dabelea D, D’Agostino R Jr, Imperatore G, Lawrence JM, Liese AD, Liu L, Marcovina S, Rodriguez B, SEARCH for Diabetes in Youth Study Group: Diabetes in African American youth: prevalence, incidence, and clinical characteristics: the SEARCH for Diabetes in Youth Study. Diabetes Care 2009, 32(Suppl 2):S112-S122.
• [38]Geil P, Shane-McWhorter L: Dietary supplements in the management of diabetes: potential risks and benefits. J Am Diet Assoc 2008, 108:S59-S65.
• [39]Ernst E: Complementary medicine: its hidden risks. Diabetes Care 2001, 24:1486-1488.
• [40]Bell RA, Stafford JM, Arcury TA, Snively BM, Smith SL, Grzywacz JG, Quandt SA: Complementary and Alternative Medicine Use and Diabetes Self-Management Among Rural Older Adults. Complement Health Pract Rev 1 2006, 11(2):95-106.
• [41]Garrow D, Egede LE: Association between complementary and alternative medicine use, preventive care practices, and use of conventional medical services among adults with diabetes. Diabetes Care 2006, 29:15-19.
• [42]Nguyen LT, Davis RB, Kaptchuk TJ, Phillips RS: Use of complementary and alternative medicine and self-rated health status: results from a national survey. J Gen Intern Med 2011, 26(4):399-404.
• [43]Neiberg RH, Aickin M, Grzywacz JG, Lang W, Quandt SA, Bell RA, Arcury TA: Occurrence and co-occurrence of types of complementary and alternative medicine use by age, gender, ethnicity, and education among adults in the United States: the 2002 National Health Interview Survey (NHIS). J Altern Complement Med 2011, 17:363-370.
• [44]Wolsko PM, Eisenberg DM, Davis RB, Ettner SL, Phillips RS: Insurance coverage, medical conditions, and visits to alternative medicine providers: results of a national survey. Arch Intern Med 2002, 162:281-287.
• [45]Baranowski T: Methodologic issues in self-report of health behavior. J Sch Health 1985, 55:179-182.
• [46]Newell SA, Girgis A, Sanson-Fisher RW, Savolainen NJ: The accuracy of self-reported health behaviors and risk factors relating to cancer and cardiovascular disease in the general population: a critical review. Am J Prev Med 1999, 17:211-229.
• [47]Dufour MC: If you drink alcoholic beverages do so in moderation: what does this mean? J Nutr 2001, 131:552S-561S.
• [48]Brener ND, Billy JO, Grady WR: Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: evidence from the scientific literature. J Adolesc Health 2003, 33:436-457.
• [49]Harris MI, Robbins DC: Prevalence of adult-onset IDDM in the U.S. population. Diabetes Care 1994, 17(11):1337-1340.
• [50]Maddigan SL, Majumdar SR, Toth EL, Feeny DH, Johnson JA: Health-related quality of life deficits associated with varying degrees of disease severity in type-2 diabetes. Health Qual Life Outcomes 2003, 1:78. BioMed Central Full Text
• [51]Young BA, Lin E, Von KM, Simon G, Ciechanowski P, Ludman EJ, Everson-Stewart S, Kinder L, Oliver M, Boyko EJ, Katon WJ: Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. Am J Manag Care 2008, 14:15-23.
• [52]Honda K, Jacobson JS: Use of complementary and alternative medicine among United States adults: the influences of personality, coping strategies, and social support. Prev Med 2005, 40:46-53.
• [53]van Kleffens T, van Baarsen B, van Leeuwen E: The medical practice of patient autonomy and cancer treatment refusals: a patients’ and physicians’ perspective. Soc Sci Med 2004, 58:2325-2336.
• [54]Vincent C, Furnham A, Willsmore M: The perceived efficacy of complementary and orthodox medicine in complementary and general practice patients. Health Educ Res 1995, 10:395-405.
• [55]McGregor KJ, Peay ER: The choice of alternative therapy for health care: testing some propositions. Soc Sci Med 1996, 43:1317-1327.
• [56]Swartzman LC, Harshman RA, Burkell J, Lundy ME: What accounts for the appeal of complementary/alternative medicine, and what makes complementary/ alternative medicine “alternative”? Med Decis Making 2002, 22:431-450.