Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gibson, N. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gibson, N. P.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Diabetes Care 25:411, 2002
© 2002 by the American Diabetes Association, Inc.

Letters: Comments and Responses
Letters

Response to Ernst

Nathaniel P. Gibson, ND

From the Department of Naturopathic Medicine, Bastyr University, Bothell, Washington

Ernst (1) makes several valid and important points regarding complementary and alternative medicine (CAM) use. The benefit/risk ratio of CAM therapies should be evaluated in the same way that conventional therapies are. Patients often lack appropriate education to make these choices. Advice from untrained retail staff is often unreliable. The popular media often provides unsatisfactory coverage of health care issues.

However, through the use of anecdote, selective use of data, and oversimplification, Ernst reaches some unfounded conclusions. Consider that it would be easy to construct a similarly misleading portrayal of conventional medicine by focusing on the alarming rate of adverse drug reactions (the fourth leading cause of death in the U.S.) (2) and ignoring conventional medicine’s great benefits.

Significantly, Ernst dismisses the potential benefits of CAM therapies in diabetic care. Implicitly, CAM therapies have not enjoyed the scientific attention that conventional treatments have received. Increasingly, however, CAM therapies suggested for diabetes have been the subject of encouraging preliminary research into their efficacy, mechanisms of action, and safety (3–10). Each therapy should be rigorously evaluated using all available evidence, not dismissed collectively.

Ernst’s commentary bears a discouragingly hostile tone. The great majority of health care providers, whether alternative or conventional, are committed to serving their patients. Patients navigate a complex and shifting health care system to the best of their ability. Let all medical professionals strive to cultivate a cooperative relationship with their peers, respect their patients, and maintain an objective approach to medical science.

Footnotes

Address correspondence to Nathaniel P. Gibson, 108 11th Ave. East, Suite C, Seattle, WA 98102. E-mail: npgibson@hotmail.com.

References

  1. Ernst E: Complementary Medicine: its hidden risks. Diabetes Care 24:1486–1488, 2001[Free Full Text]
  2. Lazarou J, Pomeranz BH, Corey PN: Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 279:1200–1205, 1998[Abstract/Free Full Text]
  3. Sotaniemi EA, Haapakoski E, Rautio A: Ginseng therapy in non-insulin dependent diabetic patients: effects on psychophysical performance, glucose homeostasis, serum lipids, serum aminoterminalpropeptide concentration, and body weight. Diabetes Care 18:1373–1375, 1995[Abstract]
  4. Bursell SE, Clermont AC, Aiello LP, Aiello LM, Schlossman DK, Feener EP, Laffel L, King GL: High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. Diabetes Care 22:1245–1251, 1999[Abstract]
  5. Sargeant LA, Wareham NJ, Bingham S, Day NE, Luben RN, Oakes S, Welch A, Khaw KT: Vitamin C and hyperglycemia in the European Prospective Investigation into Cancer–Norfolk (EPIK-Norfolk) study: a population based study. Diabetes Care 23:726–732, 2000[Abstract/Free Full Text]
  6. Vuksan V, Stavro MP, Sievenpiper JL, Beljan-Zdravkovic U, Leitter LA, Josse RG, Xu Z: Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes. Diabetes Care 23:1221–1226, 2000[Abstract/Free Full Text]
  7. Jain SK, McVie R, Smith T: Vitamin E supplementation restores glutathione and malondialdehyde to normal concentrations in erythrocytes of type 1 diabetic children. Diabetes Care 23:1389–1394, 2000[Abstract/Free Full Text]
  8. Montori VM, Farmer A, Wollan PC, Dinneen SF: Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care 23:1407–1415, 2000[Abstract/Free Full Text]
  9. Namdul T, Sood A, Ramakrishnan L, Pandey RM, Moorthy D: Efficacy of Tibetan medicine as an adjunct in the treatment of type 2 diabetes (Letter). Diabetes Care 24:176–177, 2001[Free Full Text]
  10. Hermansen K, Søndergaard M, Høie L, Carstensen M, Brock B: Beneficial effects of a soy-based dietary supplement on lipid levels and cardiovascular risk markers in type 2 diabetic subjects. Diabetes Care 24:228–233, 2001[Abstract/Free Full Text]

Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Diabetes CareHome page
E. Ernst
Response to Letter by Gibson
Diabetes Care, February 1, 2002; 25(2): 411 - 412.
[Full Text]

This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gibson, N. P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gibson, N. P.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum