Adjunctive naturopathic care for type 2 diabetes: patient-reported and clinical outcomes after one year Full Text
BMC Complementary and Alternative Medicine,

Bradley R et al. – Improvements were noted in self–monitoring of glucose, diet, self–efficacy, motivation and mood following initiation of adjunctive naturopathic care (ANC) for patients with inadequately controlled type 2 diabetes. Study participants also experienced reductions in blood glucose that exceeded those for similar patients who did not receive ANC. Randomized clinical trials will be necessary to determine if ANC was responsible for these benefits.

Methods
  • Forty patients with type 2 diabetes were invited from a large integrated health care system to receive up to eight ANC visits for up to one year.
  • Participants were required to have hemoglobin A1c (HbA1c) values between 7.5-9.5 % and at least one additional cardiovascular risk factor (i.e., hypertension, hyperlipidemia or overweight).
  • Standardized instruments were administered by telephone to collect outcome data on self-care, selfefficacy, diabetes problem areas, perceived stress, motivation, and mood.
  • Changes from baseline scores were calculated at 6- and 12-months after entry into the study.
  • Six and 12-month changes in clinical risk factors (i.e., HbA1c, lipid and blood pressure) were calculated for the ANC cohort, and compared to changes in a cohort of 329 eligible, non-participating patients constructed using electronic medical records data.
  • Between-cohort comparisons were adjusted for age, gender, baseline HbA1c, and diabetes medications.
  • Six months was prespecified as the primary endpoint for outcome assessment.

Results
  • Participants made 3.9 ANC visits on average during the year, 78 % of which occurred within six months of entry into the study.
  • At 6-months, significant improvements were found in most patient-reported measures, including glucose testing (P = 0.001), diet (P = 0.001), physical activity (P = 0.02), mood (P = 0.001), self-efficacy (P = 0.0001) and motivation to change lifestyle (P = 0.003).
  • Improvements in glucose testing, mood, self-efficacy and motivation to change lifestyle persisted at 12-months (all P < 0.005).
  • For clinical outcomes, mean HbA1c decreased by 0.90 % (P = 0.02) in the ANC cohort at 6-months, a 0.51 % mean difference compared to usual care (P = 0.07).
  • Reductions at 12-months were not statistically significant (0.34 % in the ANC cohort, P = 0.14; -0.37 % difference compared to the usual care cohort, P = 0.12).

Please login or register to follow this author.
► Click here to access Full Text, PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Internal Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Internal Medicine Articles

1 Effects of tea intake on blood pressure: A meta-analysis of 21 randomized controlled trials JACC - Journal of the American College of Cardiology, October 22, 2014    Clinical Article

2 Sweetened carbonated beverage consumption and cancer risk: Meta-analysis and review European Journal of Cancer Prevention, August 1, 2014    Evidence Based Medicine    Review Article

3 Acupuncture for chronic knee pain: a randomized clinical trial JAMA, October 1, 2014    Evidence Based Medicine    Clinical Article

4 Evaluation and treatment of older patients with hypercholesterolemia: A clinical review JAMA, October 20, 2014    Clinical Article

5 Lower versus higher hemoglobin threshold for transfusion in septic shock New England Journal of Medicine, October 7, 2014    Evidence Based Medicine    Clinical Article

6 Association between circulating 25-hydroxyvitamin D and incident type 2 diabetes: A mendelian randomisation study The Lancet Diabetes & Endocrinology, October 21, 2014    Clinical Article

7 Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review Annals of Internal Medicine, September 29, 2014    Evidence Based Medicine    Review Article    Clinical Article

8 Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial The Lancet, October 16, 2014    Evidence Based Medicine    Clinical Article
Exclusive Author Commentary

9 Total expenditures per patient in hospital-owned and physician-owned physician organizations in California JAMA, October 24, 2014    Evidence Based Medicine    Clinical Article

10 Triglycerides and cardiovascular disease The Lancet, August 19, 2014    Evidence Based Medicine    Clinical Article

11 Nut consumption and the risk of coronary artery disease: A dose–response meta-analysis of 13 prospective studies Thrombosis Research, October 22, 2014    Clinical Article

12 Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak The Lancet, October 23, 2014    Evidence Based Medicine    Clinical Article

13 Association of fat density with subclinical atherosclerosis Full Text Journal of the American Heart Association, September 19, 2014    Free full text

14 A randomized trial of epidural glucocorticoid injections for spinal stenosis New England Journal of Medicine, July 7, 2014    Evidence Based Medicine    Clinical Article

15 Ivabradine in stable coronary artery disease without clinical heart failure New England Journal of Medicine, September 2, 2014    Evidence Based Medicine    Clinical Article

16 Livebirth after uterus transplantation The Lancet, October 9, 2014    Evidence Based Medicine    Clinical Article

17 Exercises to improve function of the rheumatoid hand (SARAH): a randomised controlled trial The Lancet, October 14, 2014    Evidence Based Medicine    Clinical Article

18 Plasma triglycerides predict ten-years all-cause mortality in outpatients with type 2 diabetes mellitus: a longitudinal observational study Full Text Cardiovascular Diabetology, October 17, 2014    Free full text    Clinical Article

19 Readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia among young and middle-aged adults: a retrospective observational cohort study Full Text PLoS Medicine, October 3, 2014    Free full text    Evidence Based Medicine    Clinical Article

20 The influence of whole grain products and red meat on intestinal microbiota composition in normal weight adults: A randomized crossover intervention trial PLOS ONE, October 22, 2014    Clinical Article

Indexed Journals in Internal Medicine: New England Journal of Medicine, The Lancet, Archives of Internal Medicinemore