JDC Gems

3. The impact of unproven therapies in diabetes and the role of education

The study was presented from Jothydev’s Diabetes Research Center, Trivandrum at the International Diabetes Federation Congress 2019, organized by IDF at Busan. The Research team headed by Dr.Jothydev Kesavadev included Dr.Shaukat Sadikot, Dr.Banshi Saboo, Dr.Shashank R Joshi, Bhavya Balan Chandrika and Sunitha Jothydev.

      Diabetes being a chronic disease requires intensive self-management skills and therefore even literate patients with diabetes in Kerala, India easily fall for alternate, complementary or unproven therapies over evidence-based medicines to achieve glycemic goals effortlessly. The reasons may be attributed to the influence of centuries-old indigenous therapies, lesser cost, ease of use, socio- cultural beliefs, peer group influence and the widespread notion that alternate therapies are devoid of side effects.The study aimed to assess the impact of alternate therapies/unproven therapies on glycemic and other parameters in type 2 diabetes patients.

      73 subjects with type 2 diabetes were identified from our EMR who pursued alternate/unproven therapies in place of evidence-based medicine for a period of 8 months to one year and resumed standard diabetes care at our center in the past one year. The clinical parameters before and after pursuing alternate/unproven therapies were compared. Mean age 43.32 ± 6.79 years, mean duration of diabetes 12.92 ± 3.98, mean A1c 7.64 ± 0.87%.

      A significant worsening of the clinical parameters was observed in these subjects with diabetes who underwent alternate/unproven therapies. Being a progressive disease requiring multiple drugs in combination with lifestyle modifications, claims on “cure” for diabetes easily attracts the common man irrespective of social, economic and educational background. Such unproven therapies inflict huge economic loss; several folds increase in the treatment cost and eventually lead to complications in diabetes. Widespread diabetes education should focus on patients adhering to therapies accepted and published by global and regional scientific bodies. Restricting unproven therapy, practitioners having no acceptable educational qualifications and implementing stringent standards of practice may minimise practice risks.

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