Use of complementary and alternative medicine in children with type 1 diabetes mellitus - prevalence, patterns of use, and costs.

BACKGROUND: Complementary and alternative medicine (CAM) is increasingly used in adults and children. Studies on CAM in diabetes have mainly focused on the adult population and its use among children with type 1 diabetes has not been well characterized. OBJECTIVES: This study determines prevalence, parental reasons and motivations, perceived effectiveness, costs, and communication of CAM use. Moreover, caregiver-related variables associated with the use of CAM were investigated. METHODS: A self-completed anonymous questionnaire was administered to parents of children with type 1 diabetes in four pediatric diabetes centers in Germany (Leipzig, Berlin, Stuttgart, and Bonn). RESULTS: Two hundred and twenty eight (65.9%) of 346 families completed the survey. Mean age of the diabetic patients was 11.9 +/- 3.8 yr. Forty two (18.4%) received one or more types of CAM, with the most common types being homeopathy (14.5%), vitamins and minerals (13.7%), modified diet (12.9%), aloe vera (7.3%), and cinnamon (5.6%). Users had a significantly higher family income and parental tertiary education (p < 0.05) and stated a significantly stronger interest in self-care (p < 0.01). Parents' motivations for using CAM were the hope for an improved well-being (92.1%), to try everything (77.8%), and assumption of fewer side effects (55.2%). Costs for the entire treatment varied between less than euro100 and up to euro5000, with mostly no reimbursement. CONCLUSIONS: Use of CAM in children with type 1 diabetes is less common than that documented for adults. Parents using CAM do not question the need for insulin. When using CAM, improved well-being and quality of life are important considerations where CAM can have a role.

[Role of complementary medicine in type 1 diabetes mellitus in two Swiss centres]. / Rolle der Komplementärmedizin bei Diabetes mellitus Typ 1 in zwei Schweizer Zentren.

Insulin replacement is the only effective treatment of type 1 Diabetes mellitus (T1DM). Nevertheless, many complementary treatments are in use for T1DM. In this study we assessed by questionnaire that out of 342 patients with T1DM, 48 (14%; 13.4% adult, 18.5% paediatric; 20 male, 28 female) used complementary medicine (CM) in addition to their insulin therapy. The purpose of the use of CM was to improve general well-being, ameliorate glucose homeostasis, reduce blood glucose levels as well as insulin doses, improve physical fitness, reduce the frequency of hypoglycaemia, and control appetite. The modalities most frequently used are cinnamon, homeopathy, magnesium and special beverages (mainly teas). Thus, good collaboration between health care professionals will allow optimal patient care.

Ficha clínica de atendimento ao cliente com diabetes mellitus do tipo 1 / Type 1 diabetes mellitus customer clinical care history sheet

Diabetes Mellitus é um dos principais problemas de saúde pública, sendo a Diabetes Mellitus tipo 1 (DM1) o distúrbio endócrino-metabólico mais comum na infância. Durante o atendimento ambulatorial ao cliente com DM1, foi observado que o registro da consulta era feito em uma folha pautada apenas, sem qualquer orientação para seu preenchimento, mesmo diante de uma patologia complexa, com inúmeros dados e informações. A questão norteadora foi à necessidade de uma sistematização para um registro adequado do atendimento. O objetivo deste estudo foi elaborar uma Ficha Clínica (FC) padronizada para acompanhamento ambulatorial do cliente com DM1, com o intuito de melhorar a assistência e a segurança dos dados coletados. Ao mesmo tempo, teve o propósito de servir como instrumento facilitador para acadêmicos e profissionais de saúde para melhor aprendizagem e a avaliação dos casos. O método utilizado foi à revisão narrativa do assunto para selecionar dados e parâmetros de avaliações essenciais para compor a referida FC. Foram selecionados artigos de revisão e consensos publicados na base de dados PUBMED, LILACS, Cochrane e Scielo, produzidos no Brasil e no exterior, com a utilização dos descritores "Diabetes Mellitus tipo 1", "Guideline", além de livros atualizados sobre o tema, publicados entre os anos de 1988 a 2016. Da mesma forma, foi realizada outra revisão narrativa da literatura para aprofundar conhecimentos sobre as orientações e leis que regem o descarte correto dos resíduos sólidos perfurocortantes em domicílio, devido à extrema relevância que o tema demonstrou na assistência ao cliente com DM1. Além da elaboração de artigos sobre os temas estudados, os produtos dessas duas revisões foram: (1) "Folheto educativo (FC) para profissionais de saúde sobre destinação ambientalmente correta de perfurocortantes em domicílio" e (2) o produto principal "Ficha Clínica de atendimento ao cliente com diabetes Mellitus Tipo 1" e seu instrutivo para preenchimento. Conclusão: O estudo atingiu o objetivo proposto, com a elaboração não só de uma FC sistematizada para consulta inicial, mas também para acompanhamento da evolução clínica do diabético. Além disso, o Folheto explicativo dirigido aos profissionais de saúde sobre o descarte de resíduos perfurocortantes domiciliares complementa essa ficha clínica e possibilita uma assistência mais completa ao portador de DM1

Diabetes Mellitus is one of the main public health problems, with Diabetes Mellitus type 1 (DM1) being the most common endocrine-metabolic disorder in childhood. During ambulatory care with the DM1 client, it was observed that the registration of the consultation was done on a standardized sheet only, without any orientation for its completion, even in the face of a complex pathology, with numerous data and information. The guiding question was the need for systematization for an adequate record of care. The objective of this study was to develop a standardized Clinical Record (CR) for outpatient follow-up of patients with DM1, in order to improve the care and safety of the data collected. At the same time, it was intended to serve as a facilitating tool for academics and health professionals for better learning and case assessment. The method used was the narrative review of the subject to select data and evaluation parameters essential to compose said clinical record. We selected articles of review and consensus published in the PUBMED, LILACS, Cochrane and Scielo database, produced in Brazil and abroad, using the descriptors "Diabetes Mellitus type 1", "Guideline", and updated books on the subject , published between 1988 and 2016. In the same way, another narrative review of the literature was carried out to deepen knowledge about the guidelines and laws that govern the correct disposal of solid residues at home, due to the extreme relevance that the topic demonstrated in customer service with DM1. In addition to the elaboration of articles on the subjects studied, the products of these two reviews were: (1) "Educational brochure for health professionals about the environmentally correct destination of sharps at home" and (2) the main product "Clinical file with Type 1 Diabetes Mellitus" and it's instructive to fill. Conclusion: The study reached the proposed goal, with the elaboration not only of a systematized CR for initial consultation, but also for monitoring the clinical evolution of the diabetic. In addition, the explanatory brochure addressed to health professionals on the disposal of household hazardous waste complements this clinical file and enables a more complete assistance to the DM1 patient

Diabetes and alternative medicine: cause for concern.

'Alternative' medicines are becoming increasingly popular, and in this paper we describe our experience with alternative approaches to orthodox diabetes management. Four patients with insulin-dependent diabetes reduced or stopped their insulin in favour of therapeutic approaches including prayer, faith healing, unusual diets, and supplements of vitamins and trace elements. This resulted in ketoacidosis in three, in one case life-threatening; and weight loss and hyperglycaemia in the other. One patient developed serious retinopathy. Additionally, eight other types of alternative diabetic treatment are described, not as far as we know associated with such serious complications. These include homeopathy, reflexology, meditation, herbal treatment, 'cellular nutrition', 'subconscious healing', 'pearl therapy' (drinking milk in which pearls have been boiled) and 'astrotherapy' (typing pieces of coral around the arm). Diabetes is a chronic incurable disease, for which modern treatments remain somewhat unsatisfactory. It is therefore perhaps not surprising that some patients seek alternative treatments with more attractive claims. Diabetes health professionals need to be aware of the potential dangers associated with some of these treatments.

Tratamento para Diabetes melito tipo 1 canina através de medicamentos homeopáticos / Treatment for Diabetes mellitus type 1 canine with homeopathic medicine

A diabetes mellitus é uma doença crônica sistêmica decorrente de uma deficiência relativa ou absoluta de insulina. É uma das endocrinopatias mais comuns nos cães e pode ser fatal se não for diagnosticada e tratada adequadamente. É um conjunto de manifestações clínicas que afeta sereshumanos e animais: o fenômeno predisponente é o metabolismo anormal ou inadequado da glicose, em decorrência de uma deficiência relativa ou absoluta de insulina. É uma síndrome que compromete o metabolismo dos carboidratos, das gorduras, e das proteínas, devido a, deficiência parcial ou absoluta da secreção de insulina dada pelas células beta, produzidas pelas ilhotas de Langerhans, no pâncreas ou por redução da sensibilidade dos tecidos à insulina. O objetivo deste trabalho é revisar a literatura, os sinais clínicos, sintomas e complicações da diabetes mellitus tipo I canina e seu tratamento tradicional, e discutir a utilização de medicamentos homeopáticos. (AU)