eCAM: Attacking an Epidemic?

Diabetes 2, once reserved for those who are aging, is now rampant in adolescents in the USA. Obesity is the culprit brought on by poor eating habits, lack of exercise and a general malaise paradoxically due to wealth and not poverty (at least material). In our penultimate issue of eCAM supported by OUP, I aim to show certain advancements in evidence-based approaches. Diabetes is a condition in persons who have a high blood sugar (glucose) level either because the body does not produce enough insulin or because body cells do not properly respond to the insulin that is produced. Insulin is a hormone produced in the pancreas which enables body cells to absorb glucose, and to convert into energy. If the body cells do not absorb glucose, the glucose accumulates in the blood (hyperglycemia), leading to vascular, nerve and other complications. Serious long-term complications include cardiovascular disease, chronic renal failure and retinal damage. Adequate treatment of diabetes is thus important as well as blood pressure control and lifestyle factors such as smoking cessation and maintaining a healthy body weight. As of 2000, at least 171 million people worldwide suffer from diabetes, or 2.8% of the population. Type 2 diabetes is by far the most common, affecting 90–95% of the US’s diabetes population. Guo and colleagues (1) propose a hypothesis. They suggest one novel vanadium complex of vanadium-enriched Cordyceps sinensis (VECS), which is beneficial in preventing depression in diabetes and it can influence the longterm course of glycemic control. Vanadium compounds imitate the action of insulin, and this mimicry may have further favorable effects on levels of treatment satisfaction and mood. C. sinensis has an antidepressant-like activity, and attenuates the diabetes-induced increase in blood glucose concentrations. Thus, they suggest that the VECS may be a potential strategy for a more contemporary treatment of depression and diabetes through the co-effect of C. sinensis and vanadium. In an animal model, to test the validity of this hypothesis, investigators can examine blood glucose levels, which in turn are measured by swimming and climbing behavior in streptozotocin-induced hyperglycemic rats. This strongly supports the use of animal models to help understand disease. In contrast to the basic science approach, Aljasir et al. (2) have reviewed a clinical strategy, and that is Yoga practice for the management of diabetes in adults. All randomized controlled clinical trials comparing yoga practice with other types of intervention or with regular practice or both were examined. Two independent reviewers assessed each study for quality. The mean difference was used for summarizing the effect of each study outcome with 95% confidence intervals. Results show improvement in outcomes among patients with diabetes but these were among short-term or immediate diabetes outcomes; not all were statistically significant, leaving inconclusive results and insignificant long-term outcomes. Therefore no adverse effects were reported in any of the studies. Short-term benefits for patients with diabetes may be achieved by practicing yoga. Further research is needed in this area. Factors like quality of the trials and other methodological concerns should be improved by large randomized control trials with allocation concealment to assess the effectiveness of yoga on diabetes. Although promising, definitive recommendations for eCAM 2010;7(3)277–278 doi:10.1093/ecam/neq077