As the incidence of diabetes increases to epidemic proportions, people with diabetes are turning more and more to alternative therapies to help manage this condition, despite the availability of numerous traditional therapies. In fact, Americans spent almost $34 billion out of pocket on complementary and alternative products, practitioner visits, and materials in 2007, according to data from the National Health Interview Survey.1 It is important for health care practitioners not only to be aware of what dietary supplements their patients are taking, but also to understand how these supplements work and their possible side effects.
First, it is helpful to be familiar with some terminology. The acronym CAM stands for “complementary and alternative medicine.” According to the National Center for Complementary and Alternative Medicine, CAM consists of medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Examples of CAM therapies include acupuncture, biofeedback, chelation therapy, yoga, hypnosis, reiki or energy healing, massage, dietary therapies, meditation, tai chi, and dietary supplements.
Complementary medicine is used along with conventional medicine, whereas alternative medicine is used in place of conventional medicine. In the United States, 38% of adults (or 4 in 10) and 12% of children (or 1 in 9) use some form of complementary medicine. People with diabetes are ~ 1.6 times more likely to use CAM therapies than people without diabetes.2
Defining Dietary Supplements
Dietary supplements are one form of oral CAM therapy. The Dietary Supplement Health and Education Act (DSHEA) of 1994 defines a dietary supplement as a “product taken by mouth that contains a dietary ingredient intended to supplement the diet.” These dietary ingredients may consist of “vitamins, minerals, herbs, amino acids, and other botanicals and substances such as enzymes, organ tissues, glandulars, and metabolites.”
Dietary supplements can take various forms, …