Jan 09, 2008

Do You CAM?

David Spero

Western medicine is powerful, but it’s not perfect. And it’s not the only medicine. Many people, including thousands of people with diabetes, have turned to complementary and alternative medicine (CAM).

Complementary treatments are used along with conventional medicine. Alternative treatments are used instead of conventional medicine. In practice, any CAM treatment can be used as a complement or an alternative. CAM is also called "holistic" medicine or "integrative" medicine.

Surveys show that about 36% of Americans use some form of CAM. The National Institutes of Health have set up the National Center for Complementary and Alternative Medicine (NCCAM), which offers lots of valuable information.

Types of CAM for Diabetes
Several CAM treatments have been used for diabetes, but the ones with the best evidence behind them are:

• Traditional Chinese medicine (TCM)—this can include acupuncture, herbs, or bodywork to stimulate the body's energy ("chi") and lower blood glucose. Dozens of studies of TCM (mostly the use of herbs) showing benefit for diabetes have been published in China, but most Western docs aren't aware of them. You can read about some of these studies here.
• Herbal medicines—in addition to Chinese herbal medicine, six or more Western and Ayurvedic (Indian) herbs have shown benefits in various studies. I'll post another blog entry about herbs later on.

Other CAM treatments may not lower blood glucose, but may help with symptoms and complications of diabetes.

• Hyperbaric oxygen therapy (HBOT) helps wounds heal. HBOT has greatly reduced the rate of foot amputations in several studies, such as this one. Yet it's rarely used.
• Aromatherapy (sometimes called essential oils therapy or flower essence therapy) can help reduce stress symptoms and improve sleep.
• Chiropractic and massage therapies can help reduce pain and improve mobility.

Where's the Evidence?
Many CAM therapies have not been studied much. Others (like TCM and HBOT) have been studied, but the results are not well-known. The treatments may work quite well, but don't have public relations departments or profit potential like drugs have. And in our system, research money goes into treatments that can pay off financially.

Many therapies that were formerly CAM are now conventional, such as the use of glucosamine for arthritis. So, absence of studies doesn't prove anything. But, if a treatment has not been studied scientifically, it's hard to be sure that it's safe or effective. It can be, but you have to be careful and check it out.

If you are interested in trying a CAM practice, you can discuss the practice you are interested in with your regular doctor, check at the local library or online, or ask your support group if they have any information for you. You can find practitioners in the phone book or see their ads in local newspapers. Call and ask them questions. A list of questions you may want to ask them can be found here.

If You're Considering CAM
Before choosing a particular type of CAM or CAM practitioner, ask a few general questions. For example:

• Is treatment covered by your health insurance? How much will it cost you? Can you afford it?
• How good is the evidence that the therapy works? Are there studies? Did the studies have control groups?
• What kind of training and certification does the practitioner have?
• Does the treatment make sense to you? Are there other people you can talk to who have tried it? You can find patient evaluations of many CAM treatments at Revolution Health's Medicine Chest.
• Have the practitioners treated people like you before? Do you get a good feeling from them?
• Does the treatment call on you to give up medicines you are on or stop eating whole categories of foods? These may not be good ideas.
• How much trouble will the treatment be? Will there be a lot of pain or discomfort?
• Do you have the help you need to get through the course of treatment?

If you are using CAM, you should tell your medical doctors what you're doing and ask them if they have any concerns. You should also make a list of all your medical treatments and give it to your CAM practitioner. If you are taking prescription medicines and want to start taking herbs, you should ask your doctor and your pharmacist about them. The meds and herbs may not go well together.

You may want to keep records of your CAM treatments and how your body reacts to them. You can share these with your doctor.

CAM has helped millions of people. Many others, though, have spent lots of money, not benefited, or even been harmed. So check carefully. You can learn more at the NCCAM site (linked above) or from my book The Art of Getting Well.

What have been your experiences with CAM? Have any alternative treatments worked for you? Let us know by commenting here.

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