ETHNOPHARMACOLOGICAL THERAPIES IN THE TREATMENT OF DIABETES IN SERBIA
Abstract
The use of ethnopharmacological therapies is part of the human tradition. For centuries, they have been used in the treatment of diabetes, as well as other illnesses. The aim of this study was to examine the frequency of traditional medicine use in Serbia. The study was conducted as an online survey in February 2018. 130 people were surveyed, of which 55.38 % were people diagnosed with diabetes. The most commonly used herbal substituents were M. piperita L. (21 %), traditional herbal mixtures designed to regulate the primary and secondary diabetes complications (15%), M. chamomilla L. (13%) and pharmaceutical supplements based on traditional recipes (10 %). 100 % of people with diabetes adheres to contemporary pharmacotherapy, while 25.86 % of people without diabetes do not use pharmacotherapy, but exclusively traditional medicine. There is no significant difference between the diabetic population that uses traditional medicine (51.34 %) and the one who doesn’t (48.61 %), whereas in non-diabetic population the difference is significant (p < 0.05) so that 87.93 % of them regularly use medicinal herbs. More women than men use ethnopharmacological treatments (p < 0.05). The age of the respondents and their education also have an impact on the choice of therapy, so ethnopharmacological approaches are the most often used by faculty educated people aged 30 to 50 years. Moreover, people pay attention to the quality of supplements they use, i.e. 57.96 % of people buy them in pharmacies, 29.55 % with certified sellers, and only 12.49 % at the local market.
Korišćenje etnofarmakoloških terapija deo je ljudske tradicije. Vekovima se koriste kako u lečenju dijabetesa, tako i u terapiji drugih bolesti. Svrha ovog rada bila je ispitivanje učestalosti primene tradicionalne medicine u Srbiji. Ispitivanje je vršeno anketiranjem preko interneta, februara 2018. Ispitano je 130 ljudi, od kojih je 55,38 % ispitanika bilo sa dijagnostifikovanim dijabetesom. Najčešće korišćeni herbalni supstituenti bili su M. piperita L. (21 %), tradicionalne biljne mešavine namenjene regulaciji primarnih i sekundarnih posledica dijabetesa (15 %), M. chamomilla L. (13 %) i farmaceutski suplementi zasnovani na tradicionalnim recepturama (10 %). Savremene farmakoterapije pridržava se 100 % ljudi sa dijabetom, dok 25,86 % ispitanika bez dijabeta ne koristi farmakoterapiju, već isključivo tradicionalnu medicinu. Nema bitne razlike među dijabetičnom populacijom koja koristi (51,34 %) i koja ne koristi etnofarmakološke tretmane (48,61 %), dok je u nedijabetičnoj populaciji razlika značajna (p < 0,05), pa tako 87,93 % njih redovno primenjuje upotrebu lekovitih biljaka. Mnogo je više žena nego muškaraca sklonih etnofarmakološkim pristupima lečenja (p < 0,05). Starost ispitanika i njihovo obrazovanje takođe imaju uticaja na odabir terapije, pa su tako etnofarmakološki pristupi najzastupljeniji kod fakultetski obrazovanih ljudi starosti od 30 do 50 godina. Pokazalo se da ljudi obraćaju pažnju i na ispravnost suplemenata koje koriste, tj. 57,96 % ljudi kupuje u apoteci, 29,55 % kod sertifikovanih prodavaca, a samo 12,49 % na pijaci.
References
Adusumilli, P. S., Ben-Porat, L., Pereira, M., Roesler, D., & Leitman, I. M. (2004). The prevalence and predictors of herbal medicine use in surgical patients1 1No competing interests declared. Journal of the American College of Surgeons, 198(4), 583–590. https://doi.org/10.1016/j.jamcollsurg.2003.11.019
AlQathama, A. (2016). Natural Products & Complementary Medicines: where are we up to? British Journal of Pharmacy. https://doi.org/10.5920/bjpharm.2016.06
Alternative & Complementary Medicine Market Worth $196.87 Billion By 2025. (n.d.). Retrieved from https://www.grandviewresearch.com/press-release/global-alternative-complementary-medicine-therapies-market
Americans Spent $30.2 Billion Out-Of-Pocket On Complementary Health Approaches | NCCIH. (n.d.). Retrieved September 19, 2018, from https://nccih.nih.gov/news/press/cost-spending-06222016
Bell, R. A., Suerken, C. K., Grzywacz, J. G., Lang, W., Quandt, S. A., & Arcury, T. A. (n.d.). Complementary and alternative medicine use among adults with diabetes in the United States. Alternative Therapies in Health and Medicine, 12(5), 16–22. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17017751
Bradshaw, M. L. (2016). Knowledge, Attitudes, and Personal Use of Complementary and Alternative Medicine among Occupational Therapy Educators in the United States. Occupational Therapy In Health Care, 30(1), 80–94. https://doi.org/10.3109/07380577.2014.982315
Chang, H.-Y. A., Wallis, M., & Tiralongo, E. (2011). Use of Complementary and Alternative Medicine among People with Type 2 Diabetes in Taiwan: A Cross-Sectional Survey. Evidence-Based Complementary and Alternative Medicine : ECAM, 2011. https://doi.org/10.1155/2011/983792
Damnjanovic, I., Kitic, D., Stefanovic, N., Zlatkovic-Guberinic, S., Catic-Djordjevic, A., & Velickovic-Radovanovic, R. (2015). Herbal self-medication use in patients with diabetes mellitus type 2. Turkish Journal of Medical Sciences, 45(4), 964–71. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26422875
Esmonde, L., & Long, A. F. (2008). Complementary therapy use by persons with multiple sclerosis: Benefits and research priorities. Complementary Therapies in Clinical Practice, 14(3), 176–184. https://doi.org/10.1016/j.ctcp.2008.03.001
Farnsworth, N. R., Akerele, O., Bingel, A. S., Soejarto, D. D., & Guo, Z. (1985). Medicinal plants in therapy. Bulletin of the World Health Organization, 63(6), 965–81. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/3879679
Fisher, P., & Ward, A. (1994). Complementary medicine in Europe. BMJ (Clinical Research Ed.), 309(6947), 107–11. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8038643
Härtel, U., & Volger, E. (2004). [Use and acceptance of classical natural and alternative medicine in Germany--findings of a representative population-based survey]. Forschende Komplementarmedizin Und Klassische Naturheilkunde = Research in Complementary and Natural Classical Medicine, 11(6), 327–34. https://doi.org/10.1159/000082814
Hori, S., Mihaylov, I., Vasconcelos, J. C., & McCoubrie, M. (2008). Patterns of complementary and alternative medicine use amongst outpatients in Tokyo, Japan. BMC Complementary and Alternative Medicine, 8, 14. https://doi.org/10.1186/1472-6882-8-14
Incidencija i mortalitet od dijabetesa u Srbiji Incidence and mortality of diabetes in Serbia Registar za dijabetes u Srbiji Serbian Diabetes Registry Izveštaj br. 11 11 Report N. o. (n.d.). Retrieved from http://www.batut.org.rs/download/publikacije/2016Izvestaj dijabetes.pdf
International Diabetes Federation. IDF. (2015). Diabetes Atlas, 7th edn. Brussels, Belgium: International Diabetes Federation, 2015. http://www.diabetesatlas.org
Jatau, A. I., Aung, M. M. T., Kamauzaman, T. H. T., Chedi, B. A. Z., Sha’aban, A., & Rahman, A. F. A. (2016). Use and toxicity of complementary and alternative medicines among patients visiting emergency department: Systematic review. Journal of Intercultural Ethnopharmacology, 5(2), 191–7. https://doi.org/10.5455/jice.20160223105521
Jenkins, A.J., O’Neal Christopher, D.N., Nolan, C.J., & Januszewski, SJ. (2016) The Pathobiology of Diabetes Mellitus. Pancreatic Islet Biology. Stem Cell Biology and Regenerative Medicine. Humana Press. 1-48
Kumar, D., Bajaj, S., & Mehrotra, R. (2006). Knowledge, attitude and practice of complementary and alternative medicines for diabetes. Public Health, 120(8), 705–11. https://doi.org/10.1016/j.puhe.2006.04.010
Manya, K., Champion, B., & Dunning, T. (2012). The use of complementary and alternative medicine among people living with diabetes in Sydney. BMC Complementary and Alternative Medicine, 12, 2. https://doi.org/10.1186/1472-6882-12-2
Nguyen, H., Sorkin, D. H., Billimek, J., Kaplan, S. H., Greenfield, S., & Ngo- Metzger, Q. (2014). Complementary and Alternative Medicine (CAM) Use among Non-Hispanic White, Mexican American, and Vietnamese American Patients with Type 2 Diabetes. Journal of Health Care for the Poor and Underserved, 25(4), 1941–1955. https://doi.org/10.1353/hpu.2014.0178
Pieroni, A., Giusti, M. E., & Quave, C. L. (2011). Cross-Cultural Ethnobiology in the Western Balkans: Medical Ethnobotany and Ethnozoology Among Albanians and Serbs in the Pešter Plateau, Sandžak, South-Western Serbia. Human Ecology, 39, 333–349. https://doi.org/10.2307/41474612
Sheikhrabori, A., Dehghan, M., Ghaedi, F., & Khademi, G. R. (2017a). Complementary and Alternative Medicine Usage and Its Determinant Factors Among Diabetic Patients: An Iranian Case. Journal of Evidence-Based Complementary & Alternative Medicine, 22(3), 449–454. https://doi.org/10.1177/2156587216675079
Shikov, A. N., Pozharitskaya, O. N., Makarov, V. G., Wagner, H., Verpoorte, R., & Heinrich, M. (2014). Medicinal Plants of the Russian Pharmacopoeia; their history and applications. Journal of Ethnopharmacology, 154(3), 481–536. https://doi.org/10.1016/j.jep.2014.04.007
WHO (2012). The Regional Strategy for Traditional Medicine in the Western Pacific (2011-2020). World Health Organization, Western Pacific Region
Sheikhrabori, A., Dehghan, M., Ghaedi, F., & Khademi, G. R. (2017b). Complementary and Alternative Medicine Usage and Its Determinant Factors Among Diabetic Patients: An Iranian Case. Journal of Evidence-Based Complementary & Alternative Medicine, 22(3), 449–454. https://doi.org/10.1177/2156587216675079