Individualized homeopathic treatment in addition to conventional treatment in type II diabetic patients in Hong Kong - a retrospective cohort study.

OBJECTIVE: Glycaemic goals are not achieved in most patients with type II diabetes mellitus (T2DM), especially in those with long disease duration and taking multiple oral antidiabetic drugs (OAD). We aimed to investigate the effectiveness of individualized homeopathic treatment in glycaemic control. DESIGN: Retrospective cohort study. SETTING: At least 6 months of individualized homeopathic treatment at a private homeopathic centre in Hong Kong. PARTICIPANTS: Twenty-seven adults aged 37-84 years were treated with individualized homeopathic remedies between 2012 and 2015. Published data on 40 T2DM patients under standard conventional treatment in Hong Kong were used as a control. MAIN OUTCOME MEASURE: Change in fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) at 12-month or the last follow-up, whichever is earlier. RESULTS: Compared with the conventional treatment only group, the homeopathy group had higher baseline FPG (p = 0.044), and more patients had a long (>20 years) duration of diabetes (p = 0.006), and a history of cardiac events (p = 0.022). The mean difference in FPG in the homeopathy group was significantly greater than in the control after 12 months: -2.24 mmol/L (95% confidence interval [CI]: -3.47 to -1.01) vs 0.16 mmol/L (95% CI: -1.72 to 2.04), p = 0.001. The mean difference in glycated haemoglobin (HbA1c) was also significantly greater, -1.11% (95% CI: -2.17 to -0.05) vs 0.08% (95% CI: -1.37 to 1.53), p = 0.046. Poorer baseline glycaemic control was associated with better outcome (r = -0.750, p < 0.001), but not the duration of diabetes (r = 0.058, p = 0.772). The improvement was robust to sensitivity analyses. CONCLUSION: Individualized homeopathic treatment was associated with better glycaemic control compared with standard conventional treatment alone.

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.

A history of diabetes: from antiquity to discovering insulin.

This article, the first of a three-part series, gives a historical account of events for diabetes, dating from antiquity and its first recording in the Ebers Papyrus--an Egyptian document circa 1500 BC. This article describes initial thoughts that diabetes was linked to an alimentary complaint, and concludes with the discovery of it being a chronic systemic disease. It highlights the discoveries and also includes details of the failed attempts to locate the cause and identify a solution to the ancient mysterious disease which became known to all as diabetes mellitus. Early remedies and treatments are included. The article tells how for many centuries individuals suffered from the debilitating complaint with very little offered in terms of treatment or relief. Eventually the pancreas was identified as the causative organ and, some time later, animal experimentation resulted in the abstraction of the substance insulin. The article concludes with Frederick Banting and John Macleod being awarded the Nobel Prize in 1923 for their revolutionary discovery of insulin.

[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.

Effect of insulin concentration on bioavailability during nasal spray administration.

The bioavailability of rapid-acting insulin administered as a nasal spray was studied in 6 type 1 (insulin-dependent) diabetic patients. They received long-acting bovine insulin (Ultratardum 40 U/ml, Organon) as basal treatment at 8 a.m. Rapid-acting insulin was also administered at 8 a.m., then at noon and 6 p.m, subcutaneously on day 1 as a 100 U/ml solution and intranasally by aerosol spray as a 100 U/ml and 500 U/ml with 1% (w/v) 9 lauryl ether solution on day 2 and day 3 respectively. On days 2 and 3, the dose of insulin was at least nine times higher than the subcutaneous dose on day 1. Free and total plasma insulin concentrations were assayed after the noon insulin administration. The peaks of the free and total plasma insulin levels were reached earlier and the return to basal levels was obtained earlier after nasal insulin administration than after insulin injected subcutaneously. The bioavailability of nasal spray insulin versus subcutaneous insulin with a 100 U/ml insulin solution was similar to that with a 500 U/ml insulin solution: 5.14 +/- 0.38% (m +/- SEM) and 4.64 +/- 0.46% according to the total plasma insulin level. This study suggests that the bioavailability of nasal spray insulin is not increased by increasing insulin concentration in our experimental conditions.

Características clínicas, epidemiológicas y del tratamiento comparando la insulinoterapia por infusión continua versus las dosis horarias de la cetoacidosis en diabéticos tipo 2 / Clinical, epidemiological and treatment characteristics comparing the insulin therapy by continuous infusion versus hourly doses of ketoacidosis in type 2 diabetics

Objetivos: Conocer las características clínicas, epidemiológicas (sexo, edad, antecedentes, factores desencadenantes) y las diferencias del tratamiento con insulina endovenosa vs intramuscular en los pacientes con diagnóstico de CAD (cetoacidosis) que ingresaron en el servicio de emergencia del Hospital Nacional Daniel Alcides Carrión durante el periodo Agosto 2005-Mayo 2012. Material y métodos: Se realizó un estudio observacional, analítico, retrospectivo y transversal. Se revisaron 51 historias clínicas de pacientes con diagnóstico de CAD que ingresaron en el periodo de tiempo del estudio. Resultados: la media de la edad de los pacientes fue 46.01+/-14.5 años. El 58.8 por ciento de los pacientes fueron del sexo femenino. El 35.3 por ciento debutaban con un episodio de cetoacidosis diabética. La medicación más frecuente que recibían los pacientes eran los hipoglicemiantes orales en un 35.3 por ciento de los casos. El 47.1 por ciento de los pacientes eran obesos. EL 47.1 por ciento de los pacientes tenían el antecedente de diabetes. El 35.3 por ciento de los pacientes tuvieron poliuria como síntoma más frecuente. El 23.5 por ciento de los pacientes presentaron somnolencia. El 62.7 por ciento de los pacientes abandonaron el tratamiento. El 58.8 por ciento de los pacientes recibieron insulina por infusión continua y el 41.2 por ciento recibieron insulina por dosis horaria intramuscular. La complicación más frecuente fue la hipoglicemia que se presentó en el 45.1 por ciento de los casos. Conclusiones: La infusión continua fue más usada en los pacientes del sexo femenino (73.3 por ciento), y las dosis horarias fueron usadas con mayor frecuencia en el sexo masculino (61.9 por ciento) (P<0.05). La insulina horaria fue más usada en pacientes obesos (76.2 por ciento) (P<0.05). Hubo una diferencia estadísticamente significativa entorno al PH, potasio final y menor tiempo de hospitalización con la insulina por infusión continua, y menor dosis de insulina con las...

El caso clínico de Leonard Thompson en conmemoración del 75º aniversario del uso terapéutico de la insulina / The case of Leonard Thopson in conmemoration of 75th anniversary of clinical use to insulin

El caso clínico de Leonard Thomson es de particular interés porque fue el primer diabético en el mundo en recibir insulina, la cual fue administrada por primera vez el 11 de enero de 1922. En este artículo, presentamos la historia clínica de L.T. Desde su primer ingreso hasta su muerte por bronconeumonía y con las complicaciones de la diábetes mellitus, en el año 1935. Hoy en día, con todos los avances terapéuticos alcanzados tenemos todavía muchos aspectos que deben ser mejorados y perfeccionados. Los descubridores de la insulina hace 75 años, Banting, Best, Macleod y Collip, alcanzaron por su esfuerzo y calidad científica, uno de los acontecimientos más importantes en la historia de la terapéutica médica y son ejemplo permanente para los investigadores de este siglo que culmina