Prevalence and Determinants of Complementary and Alternative Medicine (CAM) Use Among Subjects with Diabetes Mellitus (DM) in a Tertiary Institution in South East Nigeria

Authors

  • Michael Chinweuba Abonyi Department of Internal Medicine, College of Medicine, Enugu State University, Enugu, Nigeria https://orcid.org/0000-0002-9825-8469
  • Chidiebele Malachy Ezeude Department of Internal Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria
  • Valentine Chidiebere Ugwueze Endocrine, Diabetes and Metabolism Unit, Department of Internal Medicine, Alex Ekwueme Federal University, Abakaliki Ebonyi State, Nigeria https://orcid.org/0000-0001-8284-2356
  • Chidinma Brenda Nwatu Department of Internal Medicine, College of Medicine, University of Nigeria Nsukka
  • Marcellinus Okafor Nkpozi Department of Internal Medicine, Abia State University, Uturu, Nigeria https://orcid.org/0000-0001-7709-3979
  • Ekenechukwu Esther Young Department of Internal Medicine, College of Medicine, University of Nigeria Nsukka https://orcid.org/0000-0002-2926-8524

Abstract

Background: There is limited data on the use of complementary and alternative medicine (CAM) among patients with diabetes mellitus (DM) in Nigeria. This study aims to examine the prevalence, types, and determinants of CAM use among T2DM patients in Southeast Nigeria.

Methods: This is a cross-sectional study of 250 diabetic patients who attended the DM clinic in a tertiary institution in South East Nigeria. Each participant completed a questionnaire which had sections on demography, diabetes-related information, and CAM use details. Data collated was analyzed using SPSS version 26.0 for windows.

Results: The prevalence of CAM use in this study was 34%. After adjustment; the logistic regression results showed that CAM use was significantly associated with age, and place of residence. The most commonly used type of CAM by participants were bitter leaf (Vernonia amygdalina) (56.5%), followed by bitter cola (Garcinia kola) (47%), scent leaf (African basil) (40%), moringer (20%), utazi (Gongronema latifolium) 17.7%), and aloe vera (7.1%) before the rest. The majority of CAM users were referred to use CAM by friends (68.2%), family members (25.9%), or media (14.1%). Most subjects (75.5%) used CAM concurrently with orthodox medications and only 32.9%% knew the constituents of the CAM they were using. However, gender, marital status, occupation, educational level, income, and DM duration did not significantly associate with CAM use in this study.

Key words. Complementary and Alternative Medicine. Diabetes Mellitus

Conclusions: The prevalence of CAM use was high among diabetics. Further studies to isolate and purify the constituents responsible for the anti-glycemic activity of each compound may be needed in the future.

Keywords:

Complementary and Alternative Medicine, diabetes mellitus, Southeast Nigeria

DOI

https://doi.org/10.22270/jddt.v13i12.6046

Author Biographies

Michael Chinweuba Abonyi, Department of Internal Medicine, College of Medicine, Enugu State University, Enugu, Nigeria

Department of Internal Medicine, College of Medicine, Enugu State University, Enugu, Nigeria

Chidiebele Malachy Ezeude, Department of Internal Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria

Department of Internal Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria

Valentine Chidiebere Ugwueze, Endocrine, Diabetes and Metabolism Unit, Department of Internal Medicine, Alex Ekwueme Federal University, Abakaliki Ebonyi State, Nigeria

Endocrine, Diabetes and Metabolism Unit, Department of Internal Medicine, Alex Ekwueme Federal University, Abakaliki Ebonyi State, Nigeria

Chidinma Brenda Nwatu, Department of Internal Medicine, College of Medicine, University of Nigeria Nsukka

Department of Internal Medicine, College of Medicine, University of Nigeria Nsukka

Marcellinus Okafor Nkpozi, Department of Internal Medicine, Abia State University, Uturu, Nigeria

Department of Internal Medicine, Abia State University, Uturu, Nigeria

Ekenechukwu Esther Young, Department of Internal Medicine, College of Medicine, University of Nigeria Nsukka

Department of Internal Medicine, College of Medicine, University of Nigeria Nsukka

References

Animaw W, Seyoum Y. Increasing prevalence of diabetes mellitus in a developing country and its related factors. PLoS One. 2017 ;12(11): e0187670. https://doi.org/10.1371/journal.pone.0187670 PMid:29112962 PMCid:PMC5675402

Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X, et al. Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Sci Rep 2020;10:14790. https://doi.org/10.1038/s41598-020-71908-9 PMid:32901098 PMCid:PMC7478957

Adijat OA, Folakemi E, Adejumo A, Atolagbe JE. The prevalence and Risk Factors of Diabetes Mellitus among Civil Service Workers In Osogbo, Ogun State, Nigeria. J Hypertens Manag 2021; 7:062. https://doi.org/10.23937/2474-3690/1510062

Hu FB. Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care. 2011; 34(6):1249-57. https://doi.org/10.2337/dc11-0442 PMid:21617109 PMCid:PMC3114340

Pandey A, Tripathi P, Pandey R, Srivatava R, Goswami S. Alternative therapies useful in the management of diabetes: A systematic review. J Pharm Bioallied Sci. 2011; 3(4):504-12. https://doi.org/10.4103/0975-7406.90103 PMid:22219583 PMCid:PMC3249697

Flory JH, Small DS, Cassano PA, Brillon DJ, Mushlin AI, Hennessy S. Comparative effectiveness of oral diabetes drug combinations in reducing glycosylated hemoglobin. J Comp Eff Res. 2014; 29-39. https://doi.org/10.2217/cer.13.87 PMid:24345255 PMCid:PMC3996558

Dorababu M, Prabha T, Priyambada S, Agrawal VK, Aryya NC, Goel RK. Effect of Bacopa monniera and Azadirachta indica on gastric ulceration and healing in experimental NIDDM rats. Indian J Exp Biol. 2004; 2:389-97. PMID: 15088689.

Halim EM. Lowering of blood sugar by water extract of Azadirachta indica and Abroma augusta in diabetes rats. Indian J Exp Biol. 2003;41:636-40. PMID: 15266913.

Miller JW. Proton Pump Inhibitors, H2-Receptor Antagonists, Metformin, and Vitamin B-12 Deficiency: Clinical Implications. Adv Nutr. 2018; 9: 511S-518S. https://doi.org/10.1093/advances/nmy023 PMid:30032223 PMCid:PMC6054240

Murphy CE, Rodgers PT. Effects of Thiazolidinediones on Bone Loss and Fracture. Annals of Pharmacotherapy. 2007;41(12):2014-2018. https://doi.org/10.1345/aph.1K286 PMid:17940125

Ganesan K, Rana MBM, Sultan S. Oral Hypoglycemic Medications. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482386/

Ozery M, Wadhwa R. Bromocriptine. [Updated 2022 Nov 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555948/

Undale VR, Bhosale AV, Upsani CD. Study of Pharmacodynamic Interactions between a Polyherbal Formulation BSL-150 and Metformin. Pharmaceutical Crops 2014; 5:67-76. https://doi.org/10.2174/2210290601405010067

Medagama AB, Bandara R. The use of complementary and alternative medicines (CAMs) in the treatment of diabetes mellitus: is continued use safe and effective? Nutr J. 2014 Oct 21; 13:102. https://doi.org/10.1186/1475-2891-13-102 PMid:25331834 PMCid:PMC4210501

Rahman M, Dhar PS, Anika SF, Ahmed L, Islam R, Sultana NA et al. Exploring the plant-derived bioactive substances as antidiabetic agent: An extensive review. Biomedicine & Pharmacotherapy 2022;152:0753-3322. https://doi.org/10.1016/j.biopha.2022.113217 PMid:35679719

Astin JA. Why patients use alternative medicine: Results of a national survey. JAMA. 1998; 279:1548-53. doi: 10.1001/jama.279.19.1548. PMID: 9605899. https://doi.org/10.1001/jama.279.19.1548 PMid:9605899

Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in United States: Prevelance, cost and pattern use. N Engl J Med. 1993; 328:246-52. https://doi.org/10.1056/NEJM199301283280406 PMid:8418405

Okoronkwo I, Onyia-Pat JL, Okpala P, Agbo MA, Ndu A. Patterns of Complementary and Alternative Medicine Use, Perceived Benefits, and Adverse Effects among Adult Users in Enugu Urban, Southeast Nigeria. Evid Based Complement Alternat Med. 2014; 2014:239372. https://doi.org/10.1155/2014/239372 PMid:24803945 PMCid:PMC3996953

Ezeome ER, Anarado AN. Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria. BMC Complement Altern Med. 2007; 7:28. https://doi.org/10.1186/1472-6882-7-28 PMid:17850665 PMCid:PMC2034592

Ogbera AO, Dada O, Adeyeye F, Jewo PI. Complementary and alternative medicine use in diabetes mellitus. West Afr J Med. 2010; 29(3):158-62. https://doi.org/10.4314/wajm.v29i3.68213 PMid:20665458

Ala AO, Ojo OA, Enikuomehin CA, Ajani GO, Olamoyegun MA, Akinlade AT, Olabode OR. Prevalence and Determinants of Complementary and Alternative Medicine (CAM) Use among Diabetes Patients in Southwestern Nigeria. West Afr J Med. 2020; 37(5):528-536. PMID: 33058129

Matheka DM, Demaio AR. Complementary and alternative medicine use among diabetic patients in Africa: a Kenyan perspective. Pan Afr Med J. 2013; 15:110. https://doi.org/10.11604/pamj.2013.15.110.2925 PMid:24244796 PMCid:PMC3828059

Kifle ZD. Prevalence and correlates of complementary and alternative medicine use among diabetic patients in a resource-limited setting. Metabol Open. 2021; 10:100095. https://doi.org/10.1016/j.metop.2021.100095 PMid:34041474 PMCid:PMC8141910

Khalil S.H. Pattern of use of complementary and alternative medicine among type 2 diabetes mellitus patients in Alexandria, Egypt. J Egypt Publ Health Assoc. 2013; 88(3):137-142. https://doi.org/10.1097/01.EPX.0000440994.89503.45 PMid:24374946

Niba L. Dzekem A. Navti L. Moses S. (2023) Predictors of Herbal Medicine Use amongst Adults with Type 2 Diabetes in an Urban Setting in Cameroon. Journal of Biosciences and Medicines,2023; 11:182-198. https://doi.org/10.4236/jbm.2023.114013

Lauren Chetty, Nalini Govender, Poovendhree Reddy, "Traditional Medicine Use among Type 2 Diabetes Patients in KZN", Advances in Public Health, vol. 2022, Article ID 7334080, 12 pages, 2022. https://doi.org/10.1155/2022/7334080

Baldé NM, Youla A, Baldé MD, Kaké A, Diallo MM, Baldé MA, et al Herbal medicine and treatment of diabetes in Africa: an example from Guinea. Diabetes Metab. 2006; 32(2):171-5. https://doi.org/10.1016/S1262-3636(07)70265-3 PMid:16735967

Mwangi J, Gitonga L. Perceptions and use of herbal remedies among patients with diabetes mellitus in Murang'a North District, Kenya. Open Journal of Clinical Diagnostics 2014; 04:152-72. https://doi.org/10.4236/ojcd.2014.43024

Lunyera J, Wang D, Maro V, Karia F, Boyd D, Omolo J, et al. Comprehensive Kidney Disease Assessment For Risk factors, epidemiology, Knowledge, and Attitudes (CKD AFRiKA) Study. Traditional medicine practices among community members with diabetes mellitus in Northern Tanzania: an ethnomedical survey. BMC Complement Altern Med. 2016; 16(1):282. https://doi.org/10.1186/s12906-016-1262-2 PMid:27514380 PMCid:PMC4982437

Ryan E, Pick M, Marceau C. Use of alternative medicines in diabetes mellitus. Diabet Med. 2001; 18(3):242-245. https://doi.org/10.1046/j.1464-5491.2001.00450.x PMid:11318847

Argáez-López N. The use of complementary and alternative medicine therapies in type 2 diabetic patients in Mexico. Diabetes Care. 2003; 26(8):2470-2471. https://doi.org/10.2337/diacare.26.8.2470 PMid:12882883

Rafi MA, Azad DT, Bhattacharjee M, Rahman N, Mubin KA, Rahman MA et al. A hospital-based study on complementary and alternative medicine use among diabetes patients in Rajshahi, Bangladesh. BMC Complement Med Ther 2020; 20:219. https://doi.org/10.1186/s12906-020-03021-3 PMid:32660539 PMCid:PMC7359228

Al Saeedi M. Patterns of belief and use of traditional remedies by diabetic patients in Mecca, Saudi Arabia. EMHJ-Eastern Mediterranean Health Journal. 2003; 9:99-107. https://doi.org/10.26719/2003.9.1-2.99 PMid:15562738

Naja F. Prevalence and correlates of complementary and alternative medicine use among diabetic patients in Beirut, Lebanon: a cross-sectional study. BMC Compl Alternative Med. 2014; 14(1):1-11. https://doi.org/10.1186/1472-6882-14-185 PMid:24906634 PMCid:PMC4074134

Ceylan S. Complementary and alternative medicine use among Turkish diabetes patients. Compl Ther Med. 2009;17(2):78-83. https://doi.org/10.1016/j.ctim.2008.07.003 PMid:19185265

Khalaf A.J., Whitford D.L. The use of complementary and alternative medicine by patients with diabetes mellitus in Bahrain: a cross-sectional study. BMC Compl Alternative Med. 2010; 10(1):1-5. https://doi.org/10.1186/1472-6882-10-35 PMid:20630070 PMCid:PMC2912778

Leese G, Gill G, Houghton G. Prevalence of complementary medicine usage within a diabetes clinic. Practical Diabetes International. 1997; 14(7):207-208. https://doi.org/10.1002/pdi.1150

Tan AC, Mak JC. Complementary and alternative medicine in diabetes (CALMIND): a prospective study. J Complement Integr Med 2015; 12(1):95-99. https://doi.org/10.1515/jcim-2014-0038 PMid:25581768

Ogbera AO, Ekpebegh C. Diabetes mellitus in Nigeria: The past, present and future. World J Diabetes 2014; 5(6): 905-911. https://doi.org/10.4239/wjd.v5.i6.905 PMid:25512795 PMCid:PMC4265879

Kesavadev J, Saboo B, Sadikot S, Das AK, Joshi S, Chawla R, Thacker H, Shankar A, Ramachandran L, Kalra S. Unproven Therapies for Diabetes and Their Implications. Adv Ther. 2017; 34(1):60-77. https://doi.org/10.1007/s12325-016-0439-x PMid:27864668 PMCid:PMC5216071

Emmanuel Ekpor, Eric Osei, Samuel Akyirem, Prevalence and predictors of traditional medicine use among persons with diabetes in Africa: a systematic review, International Health, 2023;, ihad080, https://doi.org/10.1093/inthealth/ihad080 PMid:37706354

Adinortey MB, Agbeko R, Boison D, Ekloh W, Kuatsienu LE, Biney EE et al. Phytomedicines Used for Diabetes Mellitus in Ghana: A Systematic Search and Review of Preclinical and Clinical Evidence. Evid Based Complement Alternat Med. 2019; 2019:6021209. https://doi.org/10.1155/2019/6021209 PMid:31118963 PMCid:PMC6500637

International Diabetes Federation. 2nd Edition. Brussels, Belgium: IDF; 2011. Diabetes Education Modules.

Ng JY, Mooghali M, Munford V. eHealth technologies assisting in identifying potential adverse interactions with complementary and alternative medicine (CAM) or standalone CAM adverse events or side effects: a scoping review. BMC Complement Med Ther2020; 20:239. https://doi.org/10.1186/s12906-020-02963-y PMid:32727531 PMCid:PMC7388448

Li S, Odedina S, Agwai I, Ojengbede O, Huo D, Olopade OI. Traditional medicine usage among adult women in Ibadan, Nigeria: a cross-sectional study. BMC Complement Med Ther. 2020; 20(1):93. https://doi.org/10.1186/s12906-020-02881-z PMid:32192455 PMCid:PMC7083039

Aliyu UM, Awosan KJ, Oche MO, Taiwo AO, Jimoh AO, Okuofo EC. Prevalence and Correlates of Complementary and Alternative Medicine use among Cancer Patients in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Nigerian Journal of Clinical Practice 2017; 20(12):1576-1583. https://doi.org/10.4103/njcp.njcp_88_17 PMid:29378990

Singh V, Raidoo DM, Harries CS. The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa. BMC Complementary and Alternative Medicine 2004; 4:3. https://doi.org/10.1186/1472-6882-4-3 PMid:15018622 PMCid:PMC356921

Ogbu CE, Oparanma CO, Kirby RS. Factors Associated with the Use of Complementary and Alternative Medicine/Therapy among United States Adults with Asthma. Healthcare. 2023; 11(7):983. https://doi.org/10.3390/healthcare11070983 PMid:37046911 PMCid:PMC10093826

Xin B, Mu S, Tan T, Yeung A, Gu D, Feng Q. Belief in and use of traditional Chinese medicine in Shanghai older adults: a cross-sectional study. BMC Complement Med Ther. 2020; 20(1):128. https://doi.org/10.1186/s12906-020-02910-x PMid:32345283 PMCid:PMC7189641

Published

15-12-2023
Statistics
Abstract Display: 306
PDF Downloads: 201
PDF Downloads: 69

How to Cite

1.
Abonyi MC, Ezeude CM, Ugwueze VC, Nwatu CB, Nkpozi MO, Young EE. Prevalence and Determinants of Complementary and Alternative Medicine (CAM) Use Among Subjects with Diabetes Mellitus (DM) in a Tertiary Institution in South East Nigeria. J. Drug Delivery Ther. [Internet]. 2023 Dec. 15 [cited 2025 Mar. 16];13(12):15-21. Available from: https://jddtonline.info/index.php/jddt/article/view/6046

How to Cite

1.
Abonyi MC, Ezeude CM, Ugwueze VC, Nwatu CB, Nkpozi MO, Young EE. Prevalence and Determinants of Complementary and Alternative Medicine (CAM) Use Among Subjects with Diabetes Mellitus (DM) in a Tertiary Institution in South East Nigeria. J. Drug Delivery Ther. [Internet]. 2023 Dec. 15 [cited 2025 Mar. 16];13(12):15-21. Available from: https://jddtonline.info/index.php/jddt/article/view/6046

Most read articles by the same author(s)