Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Advertise | Login 
 
Search Article 
  
Advanced search 
  Users Online: 191 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  

 
Table of Contents
LETTER TO THE EDITOR
Year : 2012  |  Volume : 16  |  Issue : 4  |  Page : 662-663

Self-medication with herbal remedies amongst patients of type 2 diabetes mellitus: A preliminary study


1 Department of Pharmacology, Govt. Medical College and Hospital, Chandigarh, India
2 Department of Medicine, Govt. Medical College and Hospital, Chandigarh, India

Date of Web Publication5-Jul-2012

Correspondence Address:
Jagjit Singh
Department of Pharmacology, GMCH, Chandigarh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.98041

Rights and Permissions

How to cite this article:
Singh J, Singh R, Gautam C S. Self-medication with herbal remedies amongst patients of type 2 diabetes mellitus: A preliminary study. Indian J Endocr Metab 2012;16:662-3

How to cite this URL:
Singh J, Singh R, Gautam C S. Self-medication with herbal remedies amongst patients of type 2 diabetes mellitus: A preliminary study. Indian J Endocr Metab [serial online] 2012 [cited 2020 Feb 27];16:662-3. Available from: http://www.ijem.in/text.asp?2012/16/4/662/98041

Sir,

According to the International Diabetes Federation, Type 2 diabetes mellitus (T2DM) currently affects about 246 million people throughout the world and is expected to increase to 380 million by 2025. The long-term complications of the disease notwithstanding, many patients are prone to noncompliance of prescribed medications which mostly comprise various oral hypoglycemic agents (OHAs) and insulin. During the virtually life-long therapy, many a patients are tempted to look for "alternative" remedies to this disease. It is a general notion among the population that being natural, herbal remedies are totally safe. But this is a misbelief, since these remedies are seldom standardized and often are contaminated with harmful substances. [1] Moreover, they may be potentially dangerous to the patients due to adverse effects and interactions with prescribed drugs. [2]

This preliminary study was planned with the objective to study the consumption of herbal remedies in patients with T2DM in a tertiary care teaching hospital of North India and to assess the prescribers' awareness about such herbal consumption by their patients.

One hundred consecutive patients were interviewed using a questionnaire and baseline parameters and detailed medication history was noted.

Out of the 100 patients, 91 were on drugs while 9 were not taking any medicine for diabetes (diet and/or herbals alone). OHAs were prescribed to 64 of 91 patients (70.32%), either alone 31 (48.43%) or as combinations 22 (34.37%) or along with insulin 11 (17.18%). 27 out of 91 patients (29.67%) were prescribed insulin alone due to ineffectiveness of OHAs. Glimepride was the most commonly prescribed monotherapy [13 (41.93%)], followed by gliclazide [9 (24.03%)], while metformin was most common add-on drug [26/64 (40.62%)] in combination. Thiazolidinediones were least prescribed-pioglitazone 17.18% and rosiglitazone- nil. 45% patients were taking herbal remedies along with the prescribed drugs for diabetes. Among these, majority (36/45) were taking these on their own or after advice from family members or friends. Only 5% patients consulted an herbal specialist/ayurvedic doctor before starting these. In 98% of cases physicians were unaware of this fact. Only 1 patient out of 45 disclosed the information to the prescriber while none of the patients had ever been asked specifically about their herbal remedy consumption. Overall, 58% patients reported incidence of hypoglycemic symptoms which comprised light-headedness and giddiness, cold sweats, and excessive hunger-pang type feeling. However, no case of hypoglycemic coma was recorded. As compared to 19 (32.76%) patients taking OHAs alone, 39 (67.24%) patients taking OHAs and herbals concomitantly reported hypoglycemic symptoms. 23 of 45 (51.11%) patients consumed juice of Charantia momordica either alone or with other herbs. C. memoridica juice was usually taken once a day in the morning and all the 7 patients consuming C. memoridica juice along with OHAs reported hypoglycemic symptoms. Aradichta indica leaves (whole or crushed to form juice) were consumed by 16 of 45 (35.55%) patients, usually along with other herbals. Seeds of Syzigium cumini, dried and crushed to make a powder, were consumed by 14 of 45 (31.11%) patients in combination with other herbals. Other herbal remedies included Gymnema sylvestrae, Vinea rosea, and Emblica officinalis.

The use of herbal remedies and alternative medicine is constantly increasing throughout the world. A study published in JAMA showed that 14-16% of American adult population used herbal supplements concomitantly with prescribed medication. [3] Another study in Israel showed that 36% had used some type of complimentary medicine during the past year. Of these patients, 67% used herbal remedies and 49.5% used these remedies simultaneously with conventional medicine. [4] Another study results showed that herbal consumption was prevalent in 25% of patients hospitalized in internal medicine ward. [5] Thus, there is a general trend of increased consumption of herbal remedies in patients-alone or concomitantly with allopathic medicine.

This study highlights the high prevalence of herbal intake by patients of T2DM concomitantly with prescribed medication. The study results concur with the study by Giveon et al.[4] who reported 49.5% patient taking herbal remedies simultaneously with conventional medications. The low awareness level of prescribers with respect to this is comparable to those reported by Goldstein et al. [5] Similarly, other studies have shown that the lack of awareness about herbal remedies among the medical professionals is a point which needs attention. [6],[7] There is a need to create awareness among the prescribers and patients regarding the dangers of concomitant intake of herbal remedies for diabetes. Further studies are required to look into this remedy-seeking behavior of patients so as to minimize self-medication while envisaging safety of long-term treatment of diabetes.

 
   References Top

1.Ayurvedic medicines and heavy metals. In: Christine E, editor. Vol. 19. Geneva: WHO Drug Inf; 2005. p. 215.  Back to cited text no. 1
    
2.De Smet PA. Herbal remedies. N Engl J Med 2002;347:2046-56.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.Kaufman D, Kelly J, Rosenberg L, Anderson T, Mitchell A. Recent patterns of medication use in the ambulatory adult population of the United States. JAMA 2002;287:337-44.  Back to cited text no. 3
    
4.Giveon SM, Liberman N, Klong S, Kahan E. Are people who use "natural drugs aware of their potentially harmful, side effects and reporting to family physician? Patient Educ Couns 2004;53:5-11.  Back to cited text no. 4
    
5.Goldstein LH, Elias M, Ron-Avraham G, Biniaurishvili BZ, Madjar M, Kamargash I, et al. Consumption of herbal remedies and dietary supplements amongst patients hospitalized in medical wards. Br J Clin Pharmacol 2007;64:373-80.  Back to cited text no. 5
[PUBMED]  [FULLTEXT]  
6.Clemente YN, Willams, AF, Khan K, Bernard T, Bhola S, Fortuné M, et al. A gap between acceptance and knowledge of herbal remedies by physicians: The need for educational intervention. BMC Compliment Altern Med 2005;5:20.  Back to cited text no. 6
    
7.Mikhail CN, Hearney E, Nemesure B. Increasing physician awareness of the common uses and contra-indication of herbal medicines: Utility of a case-based tutorial for residents. J Altern Complement Med 2003;9:571-6.  Back to cited text no. 7
    



This article has been cited by
1 The effect of educational intervention based on BASNEF model on self-medication behavior of type 2 diabetic patients
AliKhani Jeihooni,Maryam Barati,Amin Kouhpayeh,SeyyedMansour Kashfi,PooyanAfzali Harsini,Milad Rahbar
Indian Journal of Endocrinology and Metabolism. 2019; 23(6): 616
[Pubmed] | [DOI]
2 Effectiveness of Educational Intervention on Reducing Self-Medication Behaviors of Patients with Diabetes Type 2: Application of BASNEF Model
Ali Khan-jeyhoni,Maryam Bararti,Amin Kouhpayeh,Mansour Kashfi,Zahra Khiyali
Journal of Education and Community Health. 2019; 6(4): 257
[Pubmed] | [DOI]
3 Herbal medicine use among Type 2 diabetes mellitus patients in Nigeria: understanding the magnitude and predictors of use
Ogochukwu Ukamaka Amaeze,Roseline Iberi Aderemi-Williams,Modupeola Anuoluwapo Ayo-Vaughan,Deborah Aderoju Ogundemuren,Damilola Segun Ogunmola,Emmanuel Nwanolue Anyika
International Journal of Clinical Pharmacy. 2018;
[Pubmed] | [DOI]
4 Pattern of medication selling and self-medication practices: A study from Punjab, Pakistan
Muhammad Majid Aziz,Imran Masood,Mahreen Yousaf,Hammad Saleem,Dan Ye,Yu Fang,Albert Figueras
PLOS ONE. 2018; 13(3): e0194240
[Pubmed] | [DOI]
5 Mesenchymal Stem Cell–Conditioned Medium Improves the Proliferation and Migration of Keratinocytes in a Diabetes-Like Microenvironment
Meirong Li,Yali Zhao,Haojie Hao,Hanren Dai,Qingwang Han,Chuan Tong,Jiejie Liu,Weidong Han,Xiaobing Fu
The International Journal of Lower Extremity Wounds. 2015; 14(1): 73
[Pubmed] | [DOI]
6 Use of Complementary and Alternative Medicines (CAMs) among type 2 diabetes patients in Sri Lanka: a cross sectional survey
Arjuna B Medagama,Ruwanthi Bandara,Rajitha A Abeysekera,Buddhini Imbulpitiya,Thamudika Pushpakumari
BMC Complementary and Alternative Medicine. 2014; 14(1): 374
[Pubmed] | [DOI]
7 Struggling Towards Diagnosis: Experiences of Iranian Diabetes
Hossein Karimi Moonaghi,Hossein Namdar Areshtanab,Leila Joibari,Mohammad Arshadi Bostanabad,Mc Donald Heather
Iranian Red Crescent Medical Journal. 2014; 16(7)
[Pubmed] | [DOI]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References

 Article Access Statistics
    Viewed3176    
    Printed34    
    Emailed0    
    PDF Downloaded368    
    Comments [Add]    
    Cited by others 7    

Recommend this journal