Diabetes and Alternative Medicine; Between Myth and Reality

On May 11^st, 1999, the European Commission adopted a daring draft resolution on extremely delicate subjects, “alternative medicine” and “alternative and complementary therapies”. “Official recognition of these alternative medicines in medical schools and their practice in hospitals should be encouraged. Training of allopathic doctors in alternative and complementary therapies must be ensured by providing for adequate teaching cycles in the faculties. However, alternative medicine should be practicable by any properly trained unconventional medicine practitioner as well. Similar standards, including rules of ethics, should apply to both doctors and practitioners of alternative medicine” [1]. ‘Prevention is better than cure’ Written in popular wisdom, this adage has undoubtedly never been so applied in the as world in recent years. The enthusiasm of population for the many natural approaches that aim to prevent, and therefore preserve their health through a healthy lifestyle, is nothing new. It keeps growing. In food; the immense success of “organic” is one of the many indicators. The population is enlisting overwhelmingly in preventive “natural health” initiatives;

a. Healthy lifestyle (food, natural plants, physical activity, etc.),
b. Personal development (Yoga, meditation, hypnosis ...),
c. Alternative medicine (complementary approaches to allopathic care).

Faced to such social phenomenon, promoted by constant “word of mouth”, more than many “therapists” who are not health professionals are listed in countries with low-income and neighbor regions. This number is certainly constantly growing up. The traditional practices of prevention, personal growth, or “unconventional” care, if they have been recognized in certain countries for several years, they are developing exponentially in low-income countries. Conventional medicine carefully attempts to incorporate some of these “unconventional” approaches into its conventional practices. This is not without asking some scientific, legal, and ethical questions [2]. Occidental conventional medicine is that which is taught in medical schools with a view to obtaining the degree and title of doctor. Recognized by health systems, it is based on treatments that have been scientifically validated. This validation is achieved through successful clinical trials. They must respond favorably to strict processes in terms of authorization, implementation, ethics, and scientific relevance. This rigorous methodology aims to prove that a treatment cures tends to cure the diseases in question [3]. Much more rarely, scientific recognition of a treatment technique can also be obtained, after several years of hindsight, by the approval of the majority of professionals in the specialty concerned. Its conditions and protocols of use are then carefully defined [4]. This is how conventional medicine offers us scientific medicine with proven effectiveness. The subjects taught to future doctors in medical schools are based on “conventional” practices. The doctorate in medicine and the diplomas of the specialties assure to the patients who consult a doctor, a conventional medicine. Obtaining national diplomas for all health professionals is also based solely on teaching “conventional care”. However, alongside evidence-based medicine, there are different approaches to well-being, personal development and unconventional care that seem to contribute in certain ways to the health of population, without being conventional medicine. These practices are developing alongside ‘conventional’ medicine around the world. “They are also on the rise in the field of well-being, nutrition and aesthetic appearance “ [5]. Many doctors recommend them to their patients as an adjunct to their treatment. Hospitals even call on some of these “non-professional health” practitioners who then practice them, for example, with severe burns and other clinical cases [6]. Unconventional approaches are called-rightly or wrongly-alternative medicine, complementary medicine, natural medicine, holistic medicine, complementary therapy, or pseudo-medicine [7,8]. The World Health Organization distinguishes between “traditional medicines” and “complementary and alternative medicines”. Regarding traditional medicine, WHO states that: “Traditional medicine is very old. It is the sum of all the knowledge, skills and practices based on the theories, beliefs and experiences of different cultures, whether they are explainable or not, and which are used in the preservation of health, as well as in prevention, diagnosis, amelioration or treatment of physical and mental illnesses “ [9].

Regarding complementary and alternative medicine, WHO states that: “The term ‘complementary medicine’ or ‘alternative medicine’ is used interchangeably with ‘traditional medicine’ in some countries. They relate to a wide range of care practices that are not part of the country’s traditions and that are not integrated into the dominant health system” [9]. Diabetes is one of the most endemic diseases of our time. Currently there are more than 463 million people in the world diabetics and projected to reach 8.0% (454 million) by 2030 and 8.6% (548 million) by 2045 [10]. This is because diabetes spreads at a relatively rapid rate. If these numbers continue to increase in a linear cross over the next 50 years, the changes to come will be in the size of the demographics of the world’s population that will lead to a dramatic increase in the number of people with diabetes. According to the current general approach, the main goal in the treatment of diabetes is to minimize any rise in blood sugar (glucose) by preventing abnormally low levels of sugar in the blood. Type 1 diabetes is treated with insulin, exercise, and a proper diet. Type 2 diabetes is first treated with weight loss, proper diet, and exercise. Currently, it is believed that “diabetes is a chronic disease with no cure.” Alternative therapies and other alternative medicines have never done so well in the world, despite the assaults brought to them by the die-hards of strictly scientific medicine. Homeopathy, herbal medicine, acupuncture, and mental practices find a growing place there. Patients see it in particular as a way to support drug treatments with a search for well-being. Between the sometimes delusional promises of some influencers in the sector and genuine well-being approaches that help patients overcome the difficulties of their daily life, we have tried to see things clearly. “The anti-diabetes plant that shakes the pharmaceutical industry”! It is with this thunderous advertising slogan that a laboratories specializing in food supplements and “micro-nutrition” has been marketing their capsules for several years, a substance extracted from certain plants.

Medicinal plants “stars” of alternative anti-diabetes therapies

Supposed to improve insulin sensitivity and lower blood glucose levels, certain medicinal plants are promoted by many healers in the alter-health movement. They are generally described as food supplement, but if some of its supporters are content to recommend its use alongside drug treatment in order to be able to limit the doses (metformin for example), others simply recommend embarking on a cure to be able to stop taking medication! Chromium, nigella, rosemary; spa treatments, acupuncture, the power of thought; sophrology, hypnosis, the paleo diet; veganism, Ayurvedic massages, homeopathy ... The almost endless list is particularly weird - and includes sometimes totally contradictory proposals (paleo and veganism, for example). It brings together, for those who want to take the time to surf on Internet around the keywords diabetes and alternative medicine, dozens of “solutions” proposed by “therapists” - sometimes authentic, sometimes self-proclaimedoften also by doctors, even professors of medicine. On the one hand, therefore, health professionals, but also industrialists, marketing and communication professionals, and more or less recommendable individuals - self-proclaimed healers, “experts” in plants, masseurs, gurus… On the other hand, patients distraught by the repeated scandals in the world of drugs, worried about the heavy side effects, they sometimes observe, or simply seduced by the strong societal trend that promotes natural, “soft”, alternative medicines. Two types of treatment can be quackery: insufficiently tested remedies or illusory remedies when they are both presented as beneficial or harmless. It was judged to appreciate the insufficiently tested character of a remedy not only in the light of national but also international literature. The second sword of Damocles concerns unconventional practitioners who claim to practice “medicine” or “therapeutic care” and/or present themselves as “therapists”, by the alternative, gentle, unconventional, complementary, traditional practices, etc. This kind of care is not regulated in several underdeveloped or developing countries.

The myth of healing

A strong trend in this “alternative communication” around alternative treatments is the claim that “diabetes can be cured”- or “could be cured”, and if this is not the case today, it would be because allopathic medicines have failed to demonstrate their effectiveness! The pharmaceutical industry, in particular, is accused of deliberately concealing the power of certain plants in order to preserve its enormous profits, and of keeping patients in their condition to sell them drugs all their life... is it charlatanism? Or questioning of population to industries coupled with a real ability to support patients in relieving their anxieties, in addition to the treatment administered by the diabetologist. The two attitudes coexist, of course. You can find everything on the Internet. And the vast majority of patients seem to be right about it. Their use of alternative medicine is obviously essentially palliative in nature. Temporarily relieve the pain of neuropathies of the lower limbs; lose a few pounds more easily; fight against the side effects of treatments: these are the experiences that diabetic patients tell on the pages of social networks dedicated to these products, or in the comments of the articles of the alternative sites-without giving faith to the promises of definitive cure by the plants... It is moreover towards bodily or mental practices-yoga, meditation, sophrologythat the followers of these complementary therapies seem to be turning, in a process of research of well-being.

Diabetic people and information

Some, however, seem tempted by the magical nature of the treatments offered, especially in herbal medicine or aromatherapy. The violence of certain side effects of “classic” treatments sometimes lead them to want to completely stop the drugs, and to embark on exclusively alternative ways to treat their diabetes. But in front of them, experienced diabetics are mobilizing, in health forums and on social networks, to defend the idea that while these approaches may have certain virtues, they should in no case be implemented to treat the disease!

A complementary approach, not a substitute medicine… ambiguity

This very characteristic approach fits more generally into the complex relationship that societies have with alternative medicine. Unfortunately, very few recent studies have been done on the use of alternative medicine. In their desire to harmoniously combine “scientific” medicine and natural care, patients seem to seek more and more a “global” approach, a total care involving the psyche, well-being, and “form” as well as the body. Medical care… This quest by several companies, in particular from developing or underdeveloped countries, to have recourse to “alternative medicine”, is most often done from an economic perspective rather than as a substitute. The very heavy medical care is sometimes experienced as dehumanizing, and alternative therapies seem able to soften it a little... All the ambivalence of the view that some patients have on alternative therapies is finally summed up in a single sentence, found through the defenders of these parallel practices: “the power of thought makes it possible to heal... or in any case, to bring elements for a better life ” We find on internet a long list of methods advocating and claiming alternative or medicinal plants virtues which contribute to this well-being by considerably improving the lives of people who suffer from diabetes... After having flown around anti-drug theories , proponents of alternative medicine, sometimes explicitly admit that there is no cure for diabetes to date. Then they gently transfer the reader’s attention to these complementary well-being practices... which they distribute in their online stores and television channels shops! Because alternative medicines also constitute a considerable market, in very strong growth… from which it would be a shame for theirs promoters to do not take advantage.

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