The Usage Of Plants as a Traditional and Complementary Medicine Among Diabetic Patients in Karachi, Pakistan: an Urgent Need of Educational İntervention

A one-month cross-sectional and questionnaire-based study was carried out in a government-based teaching hospital in Peshawar (Pakistan) during January 2019. Adult population having diabetes and interact with CAM for treatment purposes were approached. The simple random sampling technique was used for the participant's enrollment. A participant has a full choice to accept or reject to participate in the study. All the information collected via a validated questionnaire and then data were entered into the Statistical Package for Social Sciences (SPSS) for further analysis.A total of 100 individuals was investigated during the study period. The sample were mostly male (n= 62), came from rural (n= 77), aged group 30-59 years (n= 83), and 56 patients had Illiterate status. The ratio of type-2 patients (n=89) was higher than as compared to type-1 DM patients (n=11). Out of these patients the prevalence of clinical characteristic included anxiety (47.1%), chronic pain (33.9%), arthritis (30.6%), concomitant heart disease (20.7%), digestive problems (22.3%), renal disease (15.7%) and allergies (4.1%).More patients (n=68) considered conventional therapy more effective for diabetes, while 7 reported CAM and 25 favored CAM plus conventional treatment strategies. About 5% of the patients completely better, 35 reported satisfactory improvement and 60 reported no change after CAM usage for diabetes. Out of all the patients, 47 patients recommend CAM usage, however, 53 didn’t in favor CAM utilization in the treatment of DM.Caralluma tuberculata (n= 11), Solanum surrattens Burm.f. (n= 10), Fagoniacretica (n= 6), Justicia adhatoda (n= 6), Consolida ambigua (n= 5), Vernonia amydalina (n= 4), A. ParvifloraBenth (n=3), Nigella sativa (n= 3), Carumcarvi (n=2), Brberis lycium Royle (n=2), Trigonellaemodi Both. (n= 2), Abelmoschus esculentus (n=2) and Citruluscolocynthis (n=2) were the most frequently CAM products. The patients further reported that, these CAM products were freely available at low cost and most often recommended by a friend, neighbor, relative and Hakeem. Another interesting fact was that, ethno medicinal local plants in Pakistan such as, Caralluma tuberculata and Solanum surrattens Burm.f. were the most frequently used CAM and highest satisfaction level among DM patients. The use of CAM products among the adult DM patients was reported in this study. The different type of attitudes, perception and beliefs towards CAM was also revealed. The patients did not report any side effects of CAM use for treatment of DM, but adverse events and side effects have been well reported previously, hence, further empirical-evidence should require and necessary about guidance on the safe and appropriate use of CAM. 

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