Natural Health Care Confusion - Make an Informed Choice
In an effort to improve their health and delay the need for medications, many people with diabetes pursue some form of natural health care. Research suggests that between 35-48% of people with diabetes have used some form of complementary medicine (Garrow et al. Diabetes Care 2006 and Yeh, et al. Diabetes Care 2003). Yet, few have a thorough understanding of what complementary medicine offers and how to select the best provider type for their needs.
What’s in a Name?
Many health practices do not fit into the conventional medical philosophy that focuses on medication, medical procedures, and surgery as therapeutic options. There are many of these “unconventional” practices including naturopathic medicine, homeopathy, acupuncture, chiropractic care, meditation, nutritional supplementation, botanical medicine, ayurvedic medicine, and many, many more. These “unconventional” practices are often referred to as “alternative”, “complementary”, and/or “integrative”
The National Institutes of Health (NIH) offers the following definitions:
“Complementary medicine” is unconventional medicine used together with conventional medicine.
“Alternative medicine” is used in place of conventional medicine.
“Integrative medicine” refers to complementary/alternative medicine with some high quality research support combined with conventional medicine.
The differences between provider types, and the type of practice, become less important as more and more research supports the value of complementary practices.
Naturopathic medicine is a whole medical system that includes nutritional counseling, lifestyle education, behavioral counseling, nutritional supplementation, botanical medicines, homeopathy, and various forms of physical or manual medicine. In many states, naturopathic physicians attend four to five years of medical school and use prescription medication when needed. Naturopathic physicians are defined by the NIH as “alternative” however in many ways naturopathic physicians are the first licensed integrative medicine providers.
How is Naturopathic Medicine Different?
Naturopathic medicine is a whole medical system- a combination of practices linked by a philosophy. The philosophy includes very important values like “The Power of Nature to Heal”, “Doctor as Teacher”, “Do No Harm”, and “Use the Least Force”.
As good research accumulates, many complementary therapies are becoming included in conventional medicine without much attention to the philosophy from which these therapies emerged. Taking individual therapies from one philosophy and combining with another may not be in your best interest, for example traditional Chinese medicine has a separate philosophy from and uses plant medicines differently than traditional western herbalism. There is value in following the entire process with some forms of complementary medicine. In many cases, many years may be required to address health concerns that have taken many years to develop!
Diabetes and Natural Health Options
In the care of diabetes, many natural therapies have clinical research support. In fact, there are several hundred research studies published in well-recognized medical journals that suggest taking extra supplements- either nutritional, botanical, or food-based- will improve health for those with diabetes.
In my opinion, not including complementary medicine providers into your health care means you are losing valuable opinions and perspectives on treatments; in many cases complementary medicine providers may be the only ones familiar with the research that is available.
For example, clinical research shows that certain antioxidants may reduce the damage that causes nerve damage (neuropathy) in diabetes (Ziegler and Gries, Diabetes. 1997). Similarly acupuncture has been suggested to improve nerve function in patients with sluggish bowels (gastroparesis) due to diabetic changes (Abuaisha, et al. Diabetes Res Clin Pract. 1998).
Selecting a Provider
Yet the question remains, how does a person with diabetes take advantage of the proven natural options?How does someone decide what to take, who to see, and in many cases, how to pay for this care? These are challenging questions for a person already overwhelmed with medical appointments and medicines. I recommend the following approach:
Read in a bookstore or online regarding which medical philosophy is best for you. A good sources for general definitions is the NIH website (nccam.nih.gov).
Research the state and national associations that govern the complementary practice. Examples include the website of the American Association of Naturopathic Physicians (AANP) and the American Association of Oriental Medicine.
Make decisions regarding nutritional supplementation or other practices after seeing a licensed provider who received formal training
Discuss the provider’s training before taking their advice; some providers have been through very little formal training (this recommendation also includes medical doctors offering to provide recommendations on supplementation or offering complementary therapies)
Throw Out the Medication?
Many people seek complementary medical providers because they do not like taking medications, including insulin. I encourage patients to be very careful if this is their reason for seeking complementary care. Ensuring your blood sugar is very well controlled (this should include a discussion with all of your doctors) is the most important factor in your health and long life!
Ensuring your blood sugar is very well controlled... is the most important factor in your health and long life!
A safe approach is to put a limit on the amount of time you are trying unproven therapies to help control your blood sugar- I recommend six months maximum. If you are not seeing significant health improvements within this time period, I recommend using medications to control your blood sugar. This does not mean you need to stop other treatment, simply that getting your blood sugar controlled is the first priority. Additional waiting or delaying medication may hurt your health.
Remember, no matter how good therapies may sound on the internet or in the doctor’s office, all therapies (including prescription medications) have limitations.
Ultimately there needs to be more research like that sponsored by Diabetes Action to help identify which complementary therapies are helpful in the treatment and prevention of diabetes!
Ryan Bradley, ND, MPH May, 2006