MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

How often have we heard that, even if so-called alternative medicine (SCAM) does not improve the more tangible health outcomes, at least it does improve the quality of life of those who use it. But is that popular assumprion correct?

The present study investigated the use of SCAM and its relationship with health-related quality of life (HRQOL) in patients with type 2 diabetes mellitus. A total of 421 patients with type 2 diabetes mellitus who met the inclusion criteria were recruited in this cross-sectional study. The researchers recorded the use of SCAM, such as:

  • supplements,
  • Kampo,
  • acupuncture,
  • yoga.

HRQOL was assessed by EuroQOL.

A total of 161 patients (38.2%) with type 2 diabetes mellitus used some type of SCAM. The use of supplements and/or health foods was the highest among SCAM users (112 subjects, 26.6%). HRQOL was significantly lower in patients who used some SCAM (0.829 ± 0.221) than in those without any SCAM use (0.881 ± 0.189), even after adjustments for confounding factors [F(1, 414) = 2.530, p = 0.014].

The authors concluded that proper information on SCAM is needed for patients with type 2 diabetes mellitus.

We have often discussed whether SCAM use improves or reduces QoL. The evidence is mixed.

Some studies of often poor quality suggest that SCAM improves QoL, e.g.:

However, other studies suggest that SCAM has no effect or even reduces QoL, e.g.:

The authors of the present study contribute further evidence to the discussion:

Huo et al. evaluated HRQOL in 17,923 patients with bronchial asthma using the Behavioral Risk Factor Surveillance System, and showed that HRQOL was significantly lower in patients with than in those without the use of CAM []. Opheim et al. also demonstrated that HRQOL was significantly lower in inflammatory bowel disease (IBD) patients with than in those without the use of CAM []. These findings indicate that the use of some CAM is associated with lower HRQOL. Consistent with previous findings, HRQOL was significantly lower in patients with the use of some CAM than in those without any CAM in the present study.

The issue is obviously complex. Findings would depend on the type of patient and the form of SCAM as well on a multitude of other factors. Moreover, it is often unclear what was the cause and what the effect: did SCAM cause low (or high) QoL or did the latter just prompt the use of the former?

In view of this confusion, it is probably safe to merely conclude that the often-heard blanket statement that SCAM improves QoL is not nearly as certain as SCAM enthusiasts want it to be.

14 Responses to Diabetics who use so-called alternative medicine (SCAM) have a lower quality of life

  • Many of us CAM users do have some high expectations of CAM around 87% of publications although after 40 years my CAM expectations have been lowered hardly surprisingly but not enough to stop me using it when i want.
    https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-020-03157-2

    However as you can see from this paper 37% of publications point to a dissatisaction of current EBM treatments. Not sure if any research has quantified these numbers in recent years with covid no doubt interupting things. However, this must mean that many people do come to CAM after trying EBM.

    • What is the thread count of that magic carpet you are riding? Asking for a friend.

    • Let’s face it, JK, you provided a link to a paper that is unrelated to Diabetics who use so-called alternative medicine (SCAM) have a lower quality of life.

      The only occurrence of the term “quality of life” was for cancer patients, not for diabetics nor for patients with any other condition, despite the fact that quality of life was indeed mentioned in the included studies that I looked at. I think that’s called selective reporting or reporting bias.

      • Not only the paper JK touted is unrelated to the current topic but also the conclusion he draws from that paper is biased.

        After reading the not-so-difficult paper, JK concludes:

        However, this must mean that many people do come to CAM after trying EBM.

        Results reported in the paper disagree with JK’s conclusions. Bolding mine.

        231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05).

        Proper conclusion to draw from these results are: most people who use CAM have a preconceived notion that CAM is safe and beneficial, a minority of CAM users fall under the category of EBM dissatisfied.

        Now, back to flying carpets…..

  • The authors in Mori et al don’t seem to mention whether the subjects of the survey differed in rate of use and quality of compliance with conventional treatments between the CAM and non-CAM respondents, not even as something that might be a cause for the difference.

    I’d have though that that might well be a contributory factor to the difference in QOL outcomes.

  • There is a very unhealthy obsession on this forum to attack SCAM. But I rarely – of ever – see any criticism of conventional medical care – why is that I wonder?
    Read this report – I have many more similar reports for those of you that have an unbiased point of view:

    https://www.bbc.co.uk/news/health-67548296

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